Flashcards in Chapter 5 - Scoliosis and Short Leg Deck (20):
At what age should children be examined for scoliosis?
Steps to examine for scoliosis (3)
1. Examine levelness of occiput, shoulders, crests, PSIS, trochanters
2. Bend forward at waist and look for prominent rib angles
3. Screen for lumbosacral dysfunctions that may cause a short leg
Cobb angle - how to measure (3)
1. Draw "horizontal" lines along the vertebral body of the extreme ends
2. Draw perpendicular lines from each of those lines
3. Measure the angle of the intersection of those lines
Severity of scoliosis...
Mild = 5-15 degrees
Moderate = 20-45 degrees
Severe = 50+ degrees
Scoliosis - when is respiratory function compromised?
Scoliosis - When is cardiovascular function compromised?
Congenital cause of scoliosis
Malformation of vertebrae
Most often progressive
Neuromuscular causes of scoliosis (4)
Polio, Cerebral Palsy, Duchenne's, Meningomyelocele
Acquired causes of scoliosis (6)
Tumor, infection, osteomalacia, sciatica, psoas syndrome, short leg syndrome
Scoliosis 5-15 degrees - treatments
PT, OMT, Konstancin exercises
Improve FLEXIBILIY and strengthen trunk and abdominal msuculature
Scoliosis 20-45 degrees - additional treatment?
BRACE W/ SPINAL ORTHOTIC
Scoliosis 50+% - treatment?
Surgery IF respiratory compromise OR progression
Definition of short leg syndrome
1. Sacral base unleveling
2. Vertebral SB and R dysfunction
3. Innominate rotation dysfunction
MC cause of anatomic short leg syndrome
6 compensatory findings in short leg syndrome
1. Sacral base unleveling (lower on short leg side)
2. Anterior innominate on short leg side
3. Posterior innominate on long leg side
4. Lumbar SB away, R toward
5. Ferguson's angle increased 2-3 degrees
6. IL ligaments --> SI ligaments stressed on short leg side
Short leg syndrome - treatments
When is heel lift considered?
1. OMT at spine and LEs to remove SDs
2. Standing X-rays to assess femoral head heights
Heel lift IF femoral head difference is > 5mm
Heel lift - final lift height? (if chronic)
1/2 - 3/4 of the measured discrepency
FULL discrepency amount
Heel lift - fragile people?
Who are these people? (4)
1/16 inch (1.5mm), then increase 1/16 every 2 weeks
Elderly, arthritic, osteoporotic, acute pain
Heel lift - flexible people?
1/8 inch (3.2mm), the increase 1/8 every 2 weeks
Heel lift - maximum inside the shoe?