12/12/2024
I had 2 interesting cases this week. The 1st was a 14 ur old female with intermittent sharp pain around her left hip associated with "stepping wrong", no history of injury. Physical exam uncovered significant decrease in over all range of motion in both hips, which is abnormal for an adolescent female. I ordered x-ray imaging which uncovered a congenital malformation of both femur heads. Referral was made to a pediatric orthopaedic surgeon for further evaluation. The 2nd case was an 18 ur old male with acute non specific onset upper right side back pain. No history of injury. Physical exam/visual inspection demonstrated right scapular winging and obvious curvature in the thoracic spine. Xrays were ordered which revealed a 20 degree scoliosis. Although this curve measurement is substantial, it is not enough to warrant specialist consult. He can be managed conservatively with manual treatment and medication if indicated. I will mention as a point of emphasis that this young man's growth plates are now maturely developed, so going forward, he will, more likely than not, have to deal with episodes of pain that he otherwise wouldn't had his spine developed normally. Bottom line is that having your child screened for scoliosis early, in the absence of pain, is a very prudent measure, so their spine can be observed and managed as they develope into full bone maturity.
