Sunday, November 13, 2011

Name That Disease #16

Can you name the disease that the woman in this photograph has?

Image is from Wikimedia Commons and is copyright free

This woman has scoliosis, also known as curvature of the spine. It is when the spine curves away from its normal straight line when seen from the back. Muscle weakness or paralysis can often lead to a certain form scoliosis (neuromuscular). When the condition is present at birth (congenital), it is caused by abnormalities in the normal growth and development of the vertebrae and ribs. There are also forms of scoliosis that do not have a known cause. In the image above, the woman is undergoing treatment, which during the time period involved stretching out the spine and then wrapping the torso in a plaster cast.

One of the most noticeable symptoms of scoliosis is  when the shoulder blades are not on a level plane, but instead one is higher than the other. Symptoms can also include uneven hips, easily noticeable spine curvature, and pain and/or fatigue of the back. The pain or fatigue will often be associated with long periods of standing or sitting. Testing for the presence of scoliosis can vary, often depending on severity. Sometimes, the simplest exam will be performed where a device will be used to measure the curve, but x-rays and MRIs are both used as well. MRIs are usually only used if some neurological issue is noted during an exam. Since an physical exam may not be the best determinant of the severity of the curve, x-rays are often done. It is now normal for a basic screening to be done during middle school so that many cases of scoliosis can be caught before it become a serious issue.

Treatment also depends on the type and severity of the condition. Mild forms generally do not need treatment, but should be monitored in case the curve worsens. Braces are often used for more moderate forms, especially in growing children. The more severe curves are usually corrected with surgery. This involves the fusing of vertebrae, which may include rods and screws to hole the spine in position until the bones heal. In children, surgery is rarely performed before the child is finished growing since growth can continue to change the curvature of the spine. When a child is no longer growing, generally the curve will not become any worse.

Most people with scoliosis can live full lives, but the outlook again depends on severity and type. Very severe spinal curves can inhibit breathing. Other side effects can include infection associated with surgery, nerve or spinal damage, arthritis, pain, failure of the bone to re-join and emotional issues. In the case of neuromuscular or congenital scoliosis, they can be quite difficult to treat, and may not be the main point of concern when trying to improve the person's quality of life.

This is another condition that is seen in my own family. My father has fairly mild scoliosis that is controlled by exercise to strengthen the muscles.

Source is PubMed Health from the U.S. National Library of Medicine.

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