Scoliosis is a lateral curving of the spine that assumes an S or C shape. Adolescent
idiopathic scoliosis (AIS) is a spinal deformity without neuromuscular or congenital
cause. AIS is diagnosed most often in children and adolescents from ages 10-18.
How should adolescents be screened for scoliosis?
Adams Forward bend test
What intervention do you do if a spinal curve is greater than 15 degrees
orthopedic referral
what to do with a cobb angle <10 degrees
exercise regularly to maintain core strength. No need for follow up
For Cobb angle 11 to 20 degrees
follow up radiographs every 4 to 12 months depending on the age of patient and
estimated growth potential, in addition to exercise for core strength.
For Cobb angle 21 to 45 degrees
bracing 18 hours per day plus exercise for core strength.
For Cobb angle >45 degrees:
surgical correction
Patellofemoral stress syndrome
Degeneration of the posterior patellar cartilage is the cause of this condition.
Desiccation, thinning, fissure formation, and ultimately erosion of the cartilage occur.
Mechanical factors are suspected although unproven.
what is the most common cause of knee pain in joggers
Chondromalacia
Presentation of Chondromalacia
retropatellar aching that is worsened by standing up, climbing stairs, or any other form
of bent-knee strain; it is usually bilateral. Stiffness may develop after inactivity. Palpable
, grating can be elicited at the patellofemoral joint with flexion and extension of the knee.
Tx for chondromalacia
Symptomatic measures include acetaminophen or NSAIDs, ice, knee rest, and
subsequent avoidance of knee overuse. Quadriceps-strengthening exercises are
helpful. Surgery is a consideration in incapacitating cases.
Osgood-Schlatter disease (OSD) what is it
(Growing pains) usually presents during active adolescent years, during times of growth
spurts. It is an overuse syndrome characterized by pain, tenderness, and edema to the
involved knee.
Onset of osgood-schlatter disease
9yr-15yr
s/s of osgood-schlatter disease
pain aggravated by activity like running, jumping, squatting, use of stairs
a lump palpable below the knee
erythema, swelling, and tenderness localized
may present unilaterally or bilaterally
Diagnostic criterai for OSD
Plain radiographs should be ordered initially to diagnose Osgood-Schlatter disease as
well as other musculoskeletal disorders. If radiographs do not allow a definitive
diagnosis, MRI or ultrasound may be indicated.
Tx for OSD
anti-inflammatory medication (ibuprofen) to reduce pain and swelling
stretching, flexibility, and physical therapy exercises for the thigh and leg muscles
surgery may be required for persistent pain or progressive disease
RICE (rest, ice, compression, elevation) may be helpful to manage pain and
inflammation
Seizures
A seizure is a symptom of abnormal brain activity. It involves the surge of abnormal
electrical discharges from complex chemical changes in the brain cells. Seizures may
be provoked or unprovoked.
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