What is the significance of painful scoliosis in pediatric patients

The presentation of painful scoliosis is atypical in the pediatric patient. If pain is present in the pediatric patient with idiopathic scoliosis, it is typically mild, nonspecific, intermittent, and nonradiating. It is typically mechanical (improves with rest), does not awaken the patient from sleep, and does not limit activity. Persistent severe back pain should prompt the physician to further investigate the cause of the patient's symptoms. Workup (e.g. lateral spinal radiograph, magnetic resonance imaging [MRI], bone scan) is needed to rule out etiologies such as spinal tumor, spinal infection, spondylolisthesis, or Scheuermann's disease.

Clinical Evaluation of Scoliosis

Anterior superior iliac spine Umbilicus

Gauging trunk alignment with plumb line

Gauging trunk alignment with plumb line

Anterior superior iliac spine Umbilicus

A'

Measurement of leg length for determination of pelvic obliquity AB = actual leg length A'B = apparent leg lengtl

Measurement of rib hump with scoliometer

Estimation of rib ump and evaluation of curve unwinding as patient turns trunk from side to side

Measurement of rib hump with scoliometer

Estimation of rib ump and evaluation of curve unwinding as patient turns trunk from side to side

Older sister, severe curve

Younger sister, mild curve

Examination of all siblings A to detect early scoliosis

Figure 7-1. A, Clinical evaluation of scoliosis. B, Thoracic scoliosis. C, Thoracic and lumbar scoliosis. (A. Reprinted from The Netter Collection of Medical Illustrations - Musculoskeletal System, Part II, Developmental Disorders, Tumors, Rheumatic Diseases and Joint Replacements, p. 34. ©Elsevier Inc. All Rights Reserved.)

Younger sister, mild curve

Examination of all siblings A to detect early scoliosis

Figure 7-1. A, Clinical evaluation of scoliosis. B, Thoracic scoliosis. C, Thoracic and lumbar scoliosis. (A. Reprinted from The Netter Collection of Medical Illustrations - Musculoskeletal System, Part II, Developmental Disorders, Tumors, Rheumatic Diseases and Joint Replacements, p. 34. ©Elsevier Inc. All Rights Reserved.)

Back Pain Revealed

Back Pain Revealed

Tired Having Back Pains All The Time, But You Choose To Ignore It? Every year millions of people see their lives and favorite activities limited by back pain. They forego activities they once loved because of it and in some cases may not even be able to perform their job as well as they once could due to back pain.

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