Common Pediatric MSK Concerns


Kyphosis is defined as flexion (or dorsal convexity) of the spine as viewed in the sagittal plane. This may be physiologic in the thoracic spine (up to 40o) or pathologic secondary to trauma or a developmental disorder, Scheuermann's kyphosis.

This teenage male presented with a painless, fixed spinal deformity.
His clinical examination is characteristic of Scheuermann's kyphosis.
Credit: Dr. L. Davidson

Scheuermann's kyphosis is less common than scoliosis. It presents as a fixed anterior wedging of the thoracic spine. This is a painless condition of adolescence of uncertain etiology. It is differentiated from postural roundback by noting a sharp saggital plane curve on forward flexion. This is not correctable by shoulder hyperextension. X-rays are diagnostic, showing decreased anterior height of several adjacent vertebrae (at least 5o wedging of three adjacent vertebrae; vertebral endplates are typically uneven). Treatment with bracing or surgery may be required in severe cases