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A 13 year-old boy is brought to your office because his mother is concerned about his poor posture. A lateral radiograph shows thoracic kyphosis of 38 degrees. This likely represents:
Normal range of thoracic kyphosis
Adolescent idiopathic scoliosis
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The accepted range of normal T5-T12 kyphosis is 20-50 degrees. (Any degree of kyphosis at the thoracolumbar area should be considered abnormal.) Many adolescents will present with postural kyphosis, secondary to slouching shoulders and poor posture, and thus will have normal radiographs.
The review article by Tribus discusses that the indications for surgical treatment include progression of the kyphotic deformity, pain, neurologic compromise, and cosmesis.
Illustration A demonstrates two lateral spine radiographs with one representing Scheurmann's kyphosis and one showing normal kyphosis.
J Am Acad Orthop Surg. 1998 Jan-Feb;6(1):36-43. PMID: 9692939 (Link to Abstract)
Tribus, JAAOS 1998
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