Symptom Finder - Scoliosis
SCOLIOSIS
The many causes of this deformity of the spine can be recalled by applying the mnemonic MINTS.
M—Malformation prompts the recall of osteogenesis imperfecta, congenital hemivertebra, Marfan syndrome, and arthrogryposis. It should also suggest a short leg syndrome.
I—Inflammation suggests tuberculosis and fungal disease of the spine. The I should also remind one of idiopathic scoliosis, responsible for 80% of the cases.
N—Neurologic disorders that may cause scoliosis include syringomyelia, poliomyelitis, muscular dystrophy, and Friedreich ataxia.
T—Trauma should facilitate the recall of thoracolumbar sprain, compression, fracture, and herniated disk. It should also remind one of thoracoplasty and other surgical causes.
S—Systemic diseases associated with scoliosis include Paget disease, pulmonary fibrosis, and Ehlers–Danlos syndrome.
Unfortunately, rickets and osteoporosis will not be recalled with this mnemonic.
Approach to the Diagnosis
To diagnose scoliosis, have the patient bend over, and there will be asymmetry in the height of the scapulae (Adam test). Most causes of scoliosis will require only an x-ray of the spine to clarify the diagnosis. An orthopedic consult should be obtained before any further workup. Be sure to measure the leg length. If there are objective neurologic signs, a neurologist should be consulted. A bone scan, MRI, or computed
tomography (CT) scan may be necessary in difficult diagnostic problems.
Other Useful Tests
1. Complete blood count (CBC) (osteomyelitis)
2. Sedimentation rate (osteomyelitis, tuberculosis)
3. Arthritis panel (rheumatoid spondylitis)
4. Human leukocyte antigen (HLA) B-27 (rheumatoid spondylitis)
5. Pulmonary function tests (pulmonary fibrosis)
6. Bone survey (Paget disease)
7. Electromyogram (EMG) (muscular dystrophy)
The many causes of this deformity of the spine can be recalled by applying the mnemonic MINTS.
M—Malformation prompts the recall of osteogenesis imperfecta, congenital hemivertebra, Marfan syndrome, and arthrogryposis. It should also suggest a short leg syndrome.
I—Inflammation suggests tuberculosis and fungal disease of the spine. The I should also remind one of idiopathic scoliosis, responsible for 80% of the cases.
N—Neurologic disorders that may cause scoliosis include syringomyelia, poliomyelitis, muscular dystrophy, and Friedreich ataxia.
T—Trauma should facilitate the recall of thoracolumbar sprain, compression, fracture, and herniated disk. It should also remind one of thoracoplasty and other surgical causes.
S—Systemic diseases associated with scoliosis include Paget disease, pulmonary fibrosis, and Ehlers–Danlos syndrome.
Unfortunately, rickets and osteoporosis will not be recalled with this mnemonic.
Approach to the Diagnosis
To diagnose scoliosis, have the patient bend over, and there will be asymmetry in the height of the scapulae (Adam test). Most causes of scoliosis will require only an x-ray of the spine to clarify the diagnosis. An orthopedic consult should be obtained before any further workup. Be sure to measure the leg length. If there are objective neurologic signs, a neurologist should be consulted. A bone scan, MRI, or computed
tomography (CT) scan may be necessary in difficult diagnostic problems.
Other Useful Tests
1. Complete blood count (CBC) (osteomyelitis)
2. Sedimentation rate (osteomyelitis, tuberculosis)
3. Arthritis panel (rheumatoid spondylitis)
4. Human leukocyte antigen (HLA) B-27 (rheumatoid spondylitis)
5. Pulmonary function tests (pulmonary fibrosis)
6. Bone survey (Paget disease)
7. Electromyogram (EMG) (muscular dystrophy)