Scoliosis differential diagnosis

Scoliosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Scoliosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Electrocardiogram
X-Ray
Echocardiography or Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Scoliosis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Scoliosis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Scoliosis differential diagnosis
CDC on Scoliosis differential diagnosis
Scoliosis differential diagnosis in the news
Blogs on Scoliosis differential diagnosis
Directions to Hospitals Treating Scoliosis
Risk calculators and risk factors for Scoliosis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Scoliosis must be differentiated from syringomyelia, spina bifida, arnold-chiari malformation and leg length discrepancy.

Differentiating Scoliosis from other Diseases

• Scoliosis must be differentiated from other diseases that causes spinal deformity, neurologic abnormalities and gait abnormalities, such as syringomyelia, spina bifida, arnold-chiari malformation and leg length discrepancy.

Diseases	Clinical manifestations						Para-clinical findings		Gold standard	Additional findings
	Symptoms			Physical examination
							Imaging
	Atypical Curve	Muscle weakness	Numbness and tingling	Motor and sensory abnormalities	Abnormal reflexes	Babinski sign	X-ray (PA and Lateral view)	M.R.I.
Scoliosis	+	+/-	+/-	+/-	+/-	+/-	Rib or vertebral abnormalities usually seen	Abnormality that may be causing the deformity Spinal cord abnormalities may be seen	MRI	EMG and nerve conduction testing: evidence of upper motor neuron lesions.
Syringomyelia	+	+	+	+	+	+	Rib or vertebral abnormalities may be seen	Abnormality that may be causing the deformity Enlargement of the central canal of the spinal cord	MRI	Impaired ambulation and loss of penile erection when syrinx involves lumbosacral area
Spina bifida	+	+/-	+/-	+/-	+/-	+/-	Incomplete union of the posterior elements of vertebral levels	Various degrees of failure of neural tube closure Posterior sac contains meninges and/or spinal cord	MRI	Swelling on the back Tuft of hair
Arnold-chiari malformation	+/-	+	+	+	+	+	None	Tethered spinal cord Tonsillar herniation	MRI	Headache Absent gag reflex
Leg length discrepancy	+	-	-	-	-	-	Quantify the degree of leg-length discrepancy.	None	Orthoroentogram	Repeat standing x-rays with the patient standing on a block to account for the discrepancy demonstrates correction of the postural abnormality.