A 10 year old presented to ohopaedic OPD with a Curved Back, AP and Lateral Radiographs are obtained, what is the most likely cause of such deformity?
(A) Congenital (B) Neurofibromatosis (C) Idiopathic (D) Neuromuscular
(A) - In the given A-P view X-ray we could see the curvature of the spine and the presence of Hemiveebrae indicating it as a case of Scoliosis with congenital origin 3D CT image & Radiograph image showing Hemiveebrae SCOLIOSIS:* Scoliosis is defined as a lateral spinal curvature with a cobb angle of 10o or more* A curve with a Cobb angle of less than 10o is asymptomatic and does not progress; this state is known as spinal asymmetry, not Scoliosis * Cobb's angleo The angle formed by meeting of the two parallel tangential lines drawn from End Veebrae is known as Cobb's angleo Apex veebra - Fahest veebra from the spineo End veebra - Veebra that is tilted the mosto Neutral veebra - Veebra that is tilted the leasto Stable veebra - Veebra that is in line with the central sacral line * Levoscoliosis: Curvature towards the left* Dextroscoliosis: Curvature towards the right* Major/Main curvature: Curvature formed by the deformity* Minor curvature: It is a compensatory curvature Main Class and Subtype Demographic and Clinical Characteristics Idiopathic Infantile Occurs in the first 3 years of life; male preponderance; levoscoliosis is more common than dextroscoliosis Juvenile Occurs at age 4-10 years; female preponderance; dextroscoliosis is more common than levoscoliosis Adolescent Occurs at age 10-18 years; female preponderance; dextroscoliosis is more common than levoscoliosis Congenital Osteogenic Wedge - shaped veebrae, hemiveebrae, fused veebrae, unilateral bar Neuropathic Tethered cord, syringomyelia, Chiari malformation, (myelo) meningocele, diastematomyelia Developmental Skeletal dysplasia Achondroplasia Skeletal dyostosis Neurofibromatosis, osteogenesis imperfecta Neuromuscular Neuropathic (acquired) Cerebral palsy, spinocerebellar, degeneration, poliomyelitis Myopathic Muscular dystrophy of various types (eg, Duchenne dystrophy) Tumor - associated Osseous Osteoid osteoma, osteoblastoma Extraosseous Extramedullary (eg, neurofibroma) or intramedullary (eg, astrocytoma) tumor