EARLY MANIFESTATIONS OF SCOLIOTIC DISEASE
(CASE FROM PRACTICE)
DOI:
https://doi.org/10.11603/24116-4944.2025.2.15819Keywords:
scoliosis, nevus, joint, costal hump, flat feetAbstract
The aim of the study – since in most patients with spinal curvature, signs of scoliotic disease are not diagnosed during routine examination methods, we consider it necessary to pay attention to early, at first glance, insignificant signs of spinal deformities, especially in girls of pubertal age against the background of connective tissue dysplasia, for the purpose of early diagnosis and treatment.
Materials and Methods. The inpatient and outpatient documentation of the child was carefully studied. Posture was assessed by examining the spine from the front, side, and back, and the Adams test was checked. The condition of the joints and connective tissue was studied using clinical signs according to the Beighton tests, and the major and minor criteria of undifferentiated connective tissue dysplasia were assessed. The skin was examined and assessed according to the «AKORD» rule. X-ray examination – standard equipment. Magnetic resonance examination – TOSHIBA VANTAGE 1.5T device using combinations of standard pulse sequences without intravenous enhancement. The examination was performed on a SOMATOD GO NOV native computed tomography scanner.
Results and Discussion. A clinical case of rapid progression of grade III scoliosis over 8 years on the background of undifferentiated connective tissue dysplasia in a 18-year-old girl is described. The criteria for dysplastic changes were also myopia, excessive mobility of the kneecaps, bilateral flatfoot, excessive mobility of the joints of the upper extremities. Skin manifestations of dysplasia were multiple small, benign nevi on the scalp, face, and neck. Medium-sized nevi of the back were localized along the spine on the right in the area of the abnormal segment of the spine Th 5–7 at a distance of 2–3 segments. Diagnosis: right-sided, idiopathic, thoracic scoliosis scoliosis III degree; degenerative changes in the lumbar spine; disorders of statics and dynamics of the spine; deformation of the chest with the formation of a costovertebral hump on the right with persistent functional disorders; DN-II degree; bilateral flatfoot I degree; multiple, small, benign skin nevi; joint hypermobility syndrome; moderate myopia; additional chord of the left ventricle; instability of the patella (subluxations).
Conclusions. Hemangiomas, nevi localized on the skin along the spine can be considered early signs of an abnormal segment of the spine with subsequent development of scoliosis. Undifferentiated connective tissue dysplasia is an aggravating factor of scoliotic disease.
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