Review Question - QID 5235

A renal ultrasound should be obtained in a patient with congenital scoliosis.

Congenitial scoliosis has a prevalence that is estimated at 1% to 4% in general population. It is associated with systemic anomalies in up to 61% of cases. The most common anomalies are cardiac defects, genitourinary defects and spinal cord malformations. As such, additional imaging of these systems should be considered in the initial work-up of these patients.

Ruf et al. retrospectively investigated 56 consecutive operative cases of congenital scoliosis. The average age at surgery was 9.9 years (1.5–17 years). There was one wound complication, 2 hardware failures, 1 revision and no neurological complications. They concluded that one-stage posterior hemivertebra resection and instrumentation was safe in this population.

Xu et al. examined the efficacy of selective partial hemivertebra excision via posterior-only approach in 17 adolescent patients with congenital kyphoscoliosis. There were no postoperative infections and no neurological complications. They concluded that this approach may be most successful in patients aged 9 to 14 years old, with the Risser sign grades from 0–3 and Cobb angles <60°.

Illustration A from Erol et al (UPOJ, Vol 15, 2002;37-42) shows a diagram of 'types' of congenital scoliosis based on the morphology of the vertebrae.

Incorrect Answers:
Answer 1,2,5: These diagnoses do not seem to have systemic associations.
Answer 4: Charcot-Marie-Tooth Disease does not commonly manifest in the kidney.