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Erfiana Eka 08700

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A 12-year-old girl presents with her parenta positive school screening for scoliosis. Phexamination reveals shoulder and asymmetry with trunk imbalance(i.e., shiftthe midline). Neurologic and skin examin

are normal. How should the patient be evaand treated?

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Scoliosis is the most common deformity of the spinethe term scoliosismay be used by some clinicians tany curvature of the spine noted on clinical examincidental finding on radiography.

Scoliosis is defined as a lateral curvature of the spinedegrees or greater on a coronal radiographic image

patient is in a standing position (although the imrepresentation of a three-dimensional deformity).

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Scoliosis is typically categorized accor

cause :Congenital scoliosis is an anatomical anomafailure of formation or segmentation of the column which, with growth, may lead to prspinal deformity.

Neuromuscular scoliosis is deformity cadysfunction of the central nervous system (e.quadriplegia), dysfunction of the pneuromuscular unit (e.g., muscular dystrospinal muscular atrophy), or combined sen

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Evaluation

The physical examination is fundamental in the diagnosiand elimination of underlying conditions that may deformity.

Classic findings of scoliosis on examination are shoulderasymmetry, rib prominence on forward flexion on the Ada1), and asymmetry of the waist and trunk.

Axial rotation of the trunk on the Adams test can be quant"inclinometer"; rotation of less than 7 degrees is associate

probability of a curve that is less than 30 degrees on radiog

Skin examination is warranted to rule out manifneurofibromatosis (e.g., caf au lait spots, subcutaneous f

axillary freckling) and an ectodermal anomaly such as m

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"Spinal radiography" remains the standard of imag

evaluation of scoliosis. More than 90% of paidiopathic scoliosis will have a convex curvature tthoracic or left lumbar scoliosis.

An atypical direction or location of the curve shouexaminer to possible underlying conditions. A pos

radiograph of the spine from C7 to the iliarecommended, obtained with digital-imaging enhancthe patient in a standing position (Fig. 2); this viradiation exposure to the thyroid and breast tissue.

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Most patients with nonprogressive idiopathic scoliorequire treatment; often, primary care physician

periodic assessments during periods of rapid growtshows an algorithm developed from observational dmanagement of scoliosis. The algorithm is based on examination, age of the patient, and magnitude of the

Treatment with the use of "a rigid thoracolumbar orthis currently preferred for children 3 years of aadolescence who are at risk for progressive sco

patients with a curve magnitude of 25 to 45 dconsiderable growth remaining).

A brace is used to arrest the progression of scoliosi

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