Symptom Finder - Kyphosis
KYPHOSIS
The mnemonic MINT lends itself well to producing a list of possible causes of kyphosis.
M—Malformation includes mucopolysaccharidosis and Scheuermann disease. M also brings to mind menopausal osteoporosis.
I—Inflammation brings to mind tuberculosis and ankylosing spondylitis, and idiopathic prompts the recall of Paget disease (osteitis deformans) and osteoarthritis.
N—Neoplasm suggests metastatic neoplasm of the spine, which can cause kyphosis.
T—Trauma allows the recall of crush fractures of the vertebral bodies, especially in osteoporosis and osteomalacia.
This mnemonic fails to facilitate the recall of emphysema, which produces kyphosis also.
Approach to the Diagnosis
The clinical picture will help establish the diagnosis in many cases. The large skull and bowing of the legs in Paget disease, the generalized abnormalities of the skeleton in mucopolysaccharidosis, and the barrel chest and shortness of breath seen in emphysema assure the identification of the cause. X-ray of the thoracolumbar spine will be diagnostic in Paget disease, menopausal osteoporosis, rickets fractures, and Scheuermann disease.
If menopause is suspected, a serum follicle-stimulating hormone, luteinizing hormone, and estradiol will confirm the diagnosis. A human leukocyte antigen B27 antigen test should be ordered if ankylosing spondylitis is suspected. A bone scan will be useful in diagnosing ankylosing spondylitis, osteomyelitis, and metastatic carcinoma. A bone biopsy may be necessary when the diagnosis is in doubt.
The mnemonic MINT lends itself well to producing a list of possible causes of kyphosis.
M—Malformation includes mucopolysaccharidosis and Scheuermann disease. M also brings to mind menopausal osteoporosis.
I—Inflammation brings to mind tuberculosis and ankylosing spondylitis, and idiopathic prompts the recall of Paget disease (osteitis deformans) and osteoarthritis.
N—Neoplasm suggests metastatic neoplasm of the spine, which can cause kyphosis.
T—Trauma allows the recall of crush fractures of the vertebral bodies, especially in osteoporosis and osteomalacia.
This mnemonic fails to facilitate the recall of emphysema, which produces kyphosis also.
Approach to the Diagnosis
The clinical picture will help establish the diagnosis in many cases. The large skull and bowing of the legs in Paget disease, the generalized abnormalities of the skeleton in mucopolysaccharidosis, and the barrel chest and shortness of breath seen in emphysema assure the identification of the cause. X-ray of the thoracolumbar spine will be diagnostic in Paget disease, menopausal osteoporosis, rickets fractures, and Scheuermann disease.
If menopause is suspected, a serum follicle-stimulating hormone, luteinizing hormone, and estradiol will confirm the diagnosis. A human leukocyte antigen B27 antigen test should be ordered if ankylosing spondylitis is suspected. A bone scan will be useful in diagnosing ankylosing spondylitis, osteomyelitis, and metastatic carcinoma. A bone biopsy may be necessary when the diagnosis is in doubt.
