Chapter 5 - Scoliosis & Short Leg

Question 1

Scoliosis

Answer 1

lateral deviation of the spine

Question 2

What % of school-aged children develop scoliosis by 15yo?

Answer 2

5%

Question 3

What % of children w/ scoliosis have clinical Sx?

Answer 3

10%

Question 4

Female:Male ratio of children w/ scoliosis

Answer 4

4:1

Question 5

Scoliotic curve SB right - Naming?

Answer 5

Levoscoliosis

Question 6

Scoliotic curve SB left - Naming?

Answer 6

Dextroscoliosis

Question 7

Structural curve

Answer 7

fixed curve d/t vertebral wedging & shortened ligaments & muscles on the concave side

Question 8

Functional curve

Answer 8

flexible, partially or completely corrected w/ SB to opposite side

Question 9

Screening for scoliosis is recommended for

Answer 9

10-15yo

Question 10

Cobb Method of measuring

Answer 10

Draw horizontal lines from vertebral bodies of extreme ends of curves + draw perpendicular lines from the horizontals + measure acute angle

Question 11

Mild Scoliosis

Answer 11

Cobb angle = 5-15

Question 12

Moderate Scoliosis

Answer 12

Cobb angle = 20-45

Question 13

Severe Scoliosis

Answer 13

Cobb angle = >50

Question 14

> 50 degree Cobb angle may compromise

Answer 14

respiratory function

Question 15

> 75 degree Cobb angle may compromise

Answer 15

Cardiac function

Question 16

80% of all scoliosis cases are caused by

Answer 16

idiopathic causes

Question 17

Causes of scoliosis

Answer 17

idiopathic, congenital (malformation of spine), neuromuscular (muscle weakness, spasms), acquired (short leg syndrome, tumor, infection, sciatica, psoas syndrome)

Question 18

Tx for Mild Scoliosis

Answer 18

conservative - Konstancin exercises & OMT to improve flexibility and strengthen trunk

Question 19

Tx for Moderate Scoliosis

Answer 19

Mild Tx + Bracing

Question 20

Tx for Severe Scoliosis

Answer 20

Surgery

Question 21

Short Leg Syndrome

Answer 21

anatomical or functional leg length discrepancy –> sacral base unleveling, vertebral SB/R, innominate rotation

Question 22

Anatomical leg length discrepancy

Answer 22

anatomically shorter

Question 23

Most common cause of Anatomical leg length discrepancy

Answer 23

Hip replacement

Question 24

Functional leg length discrepancy

Answer 24

one leg appears shorter

Question 25

SD Findings w/ Short leg syndrome

Answer 25

sacral base lower on short leg side, anterior innominate on short leg side, posterior innominate on long leg side, lumbar spine SB away & R toward short leg, Lumbosacral angle increase 2-3, iliolumbar & SI ligament stress

Question 26

Heel lifts are considered for femoral head discrepancies of >

Answer 26

5mm

Question 27

Final lift should be __________ of the measured leg discrepancy

Answer 27

1/2-3/4

Question 28

Fragile (elderly, arthritic, etc) pts should begin w/ a heel lift of

Answer 28

1/16" & increase 1/16" every 2 weeks

Question 29

Flexible pts should begin w/ a heel lift of

Answer 29

1/8" & increase 1/8" every 2 weeks

Question 30

Maximum heel lift inside shoe

Answer 30

1/4"

Question 31

Maximum heel lift possible

Answer 31

1/2"

Question 32

If a lift >1/2" is necessary, consider

Answer 32

ipsilateral anterior sole lift