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Figure A with T5-T12 kyphosis of 8 degrees
47%
1286/2744
Figure A with T5-T12 kyphosis of 55 degrees
25%
676/2744
Figure B with T5-T12 kyphosis of 10 degrees
18%
494/2744
Figure B with T5-T12 kyphosis of 60 degrees
7%
198/2744
Figure C with T5-T12 kyphosis of 60 degrees
2%
42/2744
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In adolescent idiopathic scoliosis (AIS), the most common deformity is a right thoracic curve with associated hypokyphosis (answer choice 1). AIS occurs in children older than 10 years of age. Idiopathic scoliosis is non-progressive in the majority of patients, with the likelihood of progression increased in girls and in children with a large curvature and remaining growth. The most common deformity in AIS patients is a right thoracic deformity with hypokyphosis (normal thoracic kyphosis is approximately 20-50 degrees). Therefore scoliosis with associated kyphosis deformity raises consideration for total spine MRI to evaluate the neural axis. Cheng et al. reviewed AIS and its natural history. They reported that curve types may be isolated or a combination of right thoracic, thoracolumbar, and lumbar major curves, with right thoracic curves being most common. They concluded that the majority of clinical treatment decisions in AIS are made on the basis of spinal curve magnitude and progression. Hresko et al. reviewed idiopathic scoliosis in adolescents. They reported that >90% of patients with AIS will have a convex curvature that is right thoracic or left lumbar scoliosis. They emphasized that an atypical direction or location of the curve should alert the examiner to possible underlying conditions. Figure A depicts right thoracic scoliosis. Figure B depicts a left thoracic scoliosis. Figure C depicts a left lumbar curve. Incorrect Answers: Answer 2: This represents a right thoracic curve with thoracic hyperkyphosis. Answer 3: This represents a left thoracic curve with thoracic hypokyphosis. Answer 4: This represents a left thoracic curve with thoracic hyperkyphosis. Answer 5: This represents a left lumbar curve with thoracic hyperkyphosis.
3.4
(5)
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