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Spot Diagnosis

Discussion in 'Spot Diagnosis' started by Egyptian Doctor, May 14, 2013.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    what is your medical diagnosis ?

    spot diagnosis.jpg
     

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  2. maria123math

    maria123math Well-Known Member

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    Scoliosis.
     

  3. anshu

    anshu Guest

    scoliosis
     

  4. Gospodin Seki

    Gospodin Seki Moderator Staff Member

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    Scoliosis
     

  5. Rocket Queen

    Rocket Queen Super Moderator

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    Scoliosis
     

  6. neo_star

    neo_star Moderator

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    When scoliosis is so marked, i usually think of congenital vertebral anomaly as the underlying cause and is generally associated with cardiac and genital anomalies.



    [​IMG]




    look closely for any - "cafe au lait spots" on the body, in a manner dat fits the description of NF-I and look for other stigmata of NF-1 and also rule out Marfan's.
    In neurofibromatosis type 1, there is dystrophic type of scoliosis.

    Cause of scoliosis in Neurofibromatosis ?

    Scoliosis is the most common osseous defect associated with NF1. It may vary in severity from mild and nonprogressive to severe curvatures. The cause of this spinal deformity is unknown, but some have suggested that it is secondary to endocrine disturbances, mesodermal dysplasia, and osteomalacia (a localized neurofibromatous tumor eroding and infiltrating bone).

    Two primary types of scoliosis are observed in persons with neurofibromatosis. Dystrophic scoliosis is the short-segmented, sharply angulated type that includes fewer than 6 spinal segments. It has a tendency to progress to a severe deformity.[SUP][9, 10] [/SUP]The second type of curvature, in nondystrophic scoliosis, is similar to the idiopathic curvature observed in adolescents. This form usually involves 8-10 spinal segments. The deformity is most often convex to the right; however, this is not consistent.


    http://emedicine.medscape.com/articl...view#aw2aab6b3


    Classification of scoliosis



    • Nonstructural scoliosis
      • postural scoliosis
      • compensatory scoliosis
    • Transient structural scoliosis
      • sciatic scoliosis
      • hysterical scoliosis>
      • inflammatory scoliosis
    • Structural scoliosis
      • idiopathic (70 - 80 % of all cases)
      • congenital
      • neuromuscular
        • poliomyelitis
        • cerebral palsy
        • syringomyelia
        • muscular dystrophy
        • amyotonia congenita
        • Friedreich's ataxia
      • neurofibromatosis
      • mesenchymal disorders
        • Marfan's syndrome
        • Morquio's syndrome
        • rheumatoid arthritis
        • osteogenesis imperfecta
        • certain dwarves
      • trauma
        • fractures
        • irradiation
        • surgery




    Idiopathic genetic scoliosis accounts for about 80 % of all cases of the disorder, and has a strong female predilection (7:1). It can be sub-classified into infantile, juvenile and adolescent types, depending upon the age of onset. The most common of these is adolescent scoliosis, which by itself is by far the most common type of idiopathic scoliosis in the United States.


    ref - Scoliosis

    **********************************************************************************

    Please note: Our spine, is akin to a train...so if one carraige is hit, the impact is passed on to all the carriages. Similarly, in scoliosis...we can have deformities in all 3 segments i.e cervical, thoracic and lumbar. The primary, defect could be in any one of dese and the other segments will show compensatory / adaptive changes.



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    Reason for the rib hump : When the spine is tilted laterally ( scoliosis ), the ribs of the opposite hemithorax ( i.e convex side ), flare out and are rotated backwards. This becomes more pronounced on bending forward and can be used as a subtle way to bring out a mild scoliosis.

    in subtle cases of scoliosis, u can accentuate this bulge / rib hump, by asking the person to bend forward

    [​IMG]


    Also, during conservative management ( with exercise ) of idiopathic scoliosis esp. without bony involvement - this rotation of the hemithorax should be borne in mind while prescribing exercises. Exercises to correct both the lateral bend and the rotation, if prescribed together will hasten the improvement and give better results.

    Also the changes in the lumbar spine, will be a mirror image of the changes in the thoracic spine and exercises for correcting them should also be prescribed.
    see image below


    [​IMG]



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    Last edited: Jun 2, 2013
    1 person likes this.
  7. anshu

    anshu Guest

    ur a good guy joey,u r helping so many here,thanks indeed..
     

  8. neo_star

    neo_star Moderator

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    thx Anshu, for those sincere compliments (Y)

    lot of ppl help each one of us every single day, in ways dat we never identify as help and so do we....but it's nice when someone, every once in a while, stops by, gives us a hug and tells us dat dey appreciate what we do.

    thx, Anshu 4 ur wonderful contributions and adding some much needed spark to this forum (Y)
     

    Last edited: Jun 4, 2013
  9. Hasan

    Hasan Bronze Member

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    Scoliosis explained so nicely by Neo star.......... U guy is a real Genius........ i like it very much when most of the members here hunt for the diagnosis.... except u who not only hunts it but also give a nice try to make the fry palatable
    Good luck bro...(Y)(Y)
     

  10. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Answer : Scoliosis
     

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