Scoliosis in Pediatric Patients: Comorbid Disorders and Screening

Michael P Horan; Todd A Milbrandt

Disclosures

Pediatr Health. 2009;3(5):451-456. 

In This Article

Abstract and Introduction

Abstract

Scoliosis is one of the most commonly encountered pediatric spinal deformities. Knowledge of comorbid disorders associated with scoliosis is required in order to rule out other serious conditions. A thorough knowledge of the clinical scenarios associated with each of these disorders will help guide the pediatric practitioner in their work-up of associated conditions and possible further referrals. The aim of this review is to discuss the comorbidities associated with scoliosis and review appropriate screening tools aiding diagnosis.

Introduction

Scoliosis is one of the most commonly encountered pediatric spinal deformities. It is defined by the Scoliosis Research Society (SRS) as a lateral deviation of the spine greater than 10° with a rotational deformity.[101] Screening through a patient's history of physical examination for scoliosis is part of the standard pediatric well-child examination, yet many practitioners may be unaware of other associated conditions that may also present when a diagnosis of scoliosis is made clinically. The most common type of scoliosis is idiopathic scoliosis, comprising nearly 80% of cases,[1] yet in order to make this diagnosis, knowledge of comorbid disorders associated with scoliosis is required in order to rule out other serious conditions. The other 20% of cases comprise congenital scoliosis, neuromuscular scoliosis and syndromic-related scoliosis. Based on the clinical scenario, the work-up of these conditions may require screening tests, possibly including MRI scans, abdominal ultrasounds or echocardiograms, all of which may be costly both in terms of money and time for the patient and family. Judicious clinical discretion minimizes the number of unnecessary tests ordered and streamlines patient care. A thorough knowledge of the clinical scenarios associated with each of these disorders will help guide the pediatric practitioner in their work-up of associated conditions and possible further referrals.

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