Scoliosis

*What is Scoliosis?*

Scoliosis is an abnormal lateral curvature of the spine. Some curvature is normal to help the upper body maintain proper balance and alignment over the pelvis. It usually occurs in children ages 10 to 15. Scoliosis affects 2% of women and 0.5% of men in the general population. There are many causes of it including congenital spine deformities, genetic conditions, neuromuscular problems, and unequal length of the limbs. Other causes are cerebral palsy, spina bifida,and  muscular dystrophy. Although there are many causes associated with it, 80% of scoliosis cases have no known cause. 

*Symptoms*

There are several warning signs of scoliosis. They include shoulders at different heights, the head not centered above the pelvis, the rib cages at different heights, an uneven waist, and leaning to one side.

*Diagnosis*

There is an easy test to see whether or not you have scoliosis. It is called the Adam's Forward Bend Test. For this, you lean forward at the waist 90 degrees, and it is easy to tell if you have scoliosis by the asymmetry of the trunk or any abnormal spine curvatures. If an abnormality is noted, an x-ray will be performed.

*Treatment*

When determining the type of treatment there are many things that must be taken into consideration. These include the spinal maturity, the degree and extent of the curvature, the location of the curve, and the potential for progression. Once these have been determined there are three main types of treatment. They are observation, orthopaedic bracing, and surgery. 

This is a coronal T2-weighted MRI image showing scoliosis in the thoracic vertebrae.

http://www.scoliosisjournal.com/content/figures/1748-7161-3-3-15-l.jpg

Carotid artery aneurysm

*What is a Carotid artery aneurysm?*

An aneurysm is a bulging or ballooning in the wall of a blood vessel. It is caused when a portion of the artery wall weakens. The artery wall grows progressively thinner, increasing the likelihood that the aneurysm will burst.

*Symptoms*

The symptoms of a carotid artery aneurysm include transient ischemic attacks or stroke. Other symptoms are facial swelling, hoarseness, or difficulty swallowing from the aneurysm applying pressure to surrounding structures. 

*Treatment*

If the aneurysm is small and is not causing any problems, waiting and watching may be the best option. A CT or MRI may be ordered every 6 to 12 months to watch the aneurysm for signs of changes. If it needs to be treated there are a couple of different options. One option is surgical repair in which a bypass is made from the normal artery below the aneurysm to the normal artery above the aneurysm. Another option is endovascular stent grafting. The physician will enter an artery in the groin and insert a stent in the area of the aneurysm, allowing the blood to flow freely.

This is a coronal CT image showing an aneurysm that is eroding the sphenoid bone and protruding into the sphenoid sinus. 

www.radpod.org/2007/08