Scoliosis
Hello Dr.
Li,
I would like to ask you about my six-year-old child's abdominal X-ray report, which indicates "posture scoliosis of the lumbar spine." However, after consulting with a pediatric orthopedic specialist who reviewed the same X-ray, the doctor stated that there is no scoliosis.
They also taught us how to check for this condition ourselves.
While I feel relieved, I still have some concerns.
Could you please explain why there is a discrepancy between the doctor's diagnosis and the X-ray findings? Additionally, my child has a habit of sleeping on their side while hugging a pillow.
Could this lead to spinal scoliosis? I apologize for bothering you with these questions, and I wish you a pleasant Dragon Boat Festival.
Thank you.
rainbow, 40~49 year old female. Ask Date: 2010/06/15
Dr. Li Wenlin reply Orthopedics
Hello: In response to your question, when a radiologist interprets a standard X-ray, they are obligated to mention any minor findings.
Additionally, during an abdominal X-ray, the patient is lying down, and if they are not positioned perfectly, it can make the lumbar spine appear slightly curved.
The forward bending test is used as a screening tool for scoliosis, where a curvature of more than 10 degrees can be detected.
Therefore, the pediatric orthopedic surgeon's assessment is reliable, so there is no need for excessive concern.
However, I recommend that you regularly check your child at home every three to six months and have follow-up visits with a pediatric orthopedic specialist every six months to a year for better management.
Most cases of scoliosis have an unknown cause, with a minority being congenital.
Sleeping on one's side with a pillow does not cause scoliosis.
Wishing you all the best!
Reply Date: 2010/06/15
More Info
Dear Patient,
Thank you for your inquiry regarding your child's posture and the diagnosis of postural scoliosis. It's understandable to feel concerned when there seems to be a discrepancy between the X-ray report and the orthopedic doctor's assessment. Let's break down the situation and address your concerns.
Understanding Postural Scoliosis
Postural scoliosis refers to a temporary curvature of the spine that can occur due to poor posture rather than a structural deformity of the spine itself. In children, this condition is often related to habits, such as slouching or favoring one side while sitting or sleeping. It is important to differentiate between postural scoliosis and structural scoliosis, which is a more serious condition that involves a fixed curvature of the spine.
Discrepancy in Diagnosis
The difference in diagnosis between the X-ray report and the orthopedic doctor's assessment can arise from several factors:
1. Interpretation of X-rays: Radiologists may identify subtle curvatures or postural changes that may not be clinically significant. The orthopedic doctor, on the other hand, may focus on the functional aspects and physical examination findings, which could lead to a different conclusion.
2. Clinical Examination: The orthopedic doctor likely performed a physical examination, assessing your child's posture, flexibility, and any signs of discomfort or asymmetry. If the physical exam did not reveal any significant issues, the doctor may have concluded that there is no cause for concern.
3. Dynamic vs. Static Assessment: X-rays provide a static image of the spine, while a physical examination allows for dynamic assessment of how your child moves and holds their posture in real-time. This can provide a more comprehensive understanding of their spinal health.
Concerns About Sleeping Position
Regarding your concern about your child sleeping with a pillow and whether it could contribute to scoliosis, here are some points to consider:
- Sleeping Position: While sleeping on one side with a pillow can lead to temporary postural changes, it is unlikely to cause structural scoliosis. However, if your child consistently favors one side, it may lead to muscle imbalances or postural habits that could affect spinal alignment over time.
- Encouraging Good Posture: It’s beneficial to encourage your child to adopt a variety of sleeping positions and to ensure that their sleeping environment supports good posture. A supportive mattress and pillow that keeps the spine aligned can help.
- Regular Check-ups: Since your child is still growing, regular check-ups with a pediatrician or orthopedic specialist are essential. They can monitor any changes in posture or spinal alignment over time.
Recommendations
1. Follow-Up: If you remain concerned about your child's spinal health, consider scheduling a follow-up appointment with a pediatric orthopedic specialist for a second opinion. They can provide further evaluation and reassurance.
2. Posture Awareness: Teach your child about good posture during daily activities, such as sitting, standing, and sleeping. Encourage breaks during prolonged sitting to stretch and move around.
3. Physical Activity: Engage your child in physical activities that promote overall strength and flexibility, which can help support spinal health.
In conclusion, while the initial report indicated postural scoliosis, the orthopedic evaluation suggests that there may not be a significant concern at this time. However, maintaining awareness of your child's posture and encouraging healthy habits will be beneficial as they continue to grow. If you have further questions or concerns, please do not hesitate to reach out.
Wishing you and your family a wonderful holiday season!
Best regards,
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