Spina bifida differential diagnosis: Difference between revisions

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Revision as of 18:26, 25 January 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Differentiating [Disease name] from other Diseases

Spina bifida must be differentiated from other diseases that cause vertebral column defects, such as:

Terminal myelocystocele^[1]
Spine segmental dysgenesis^[2]
Caudal regression syndrome (sacral agenesis)^[3]
Multiple vertebral segmentation disorder^[4]
VACTERL^[5]

Differentiating Scoliosis from other Diseases

Spina bifida must be differentiated from other diseases that causes vertebral column defects, spinal deformity and neurologic abnormalities or gait abnormalities, such as arnold-chiari malformation, syringomyelia, Scoliosis, and leg length discrepancy.^[6]^[7]

	Symptoms			Physical examination			Imaging
Diseases	Clinical manifestations						Para-clinical findings		Gold standard	Additional findings
	Symptoms			Physical examination			Para-clinical findings
	Atypical Curve	Muscle weakness	Numbness and tingling	Motor and sensory abnormalities	Abnormal reflexes	Babinski sign	X-ray (PA and Lateral view)	M.R.I.
Spina bifida	+	+/-	+/-	+/-	+/-	+/-	Incomplete union of the posterior elements of vertebral levels	Various degrees of failure of neural tube closure Posterior sac contains meninges and/or spinal cord	MRI	Swelling on the back Tuft of hair
Arnold-chiari malformation	+/-	+	+	+	+	+	None	Tethered spinal cord Tonsillar herniation	MRI	Headache Absent gag reflex
Syringomyelia	+	+	+	+	+	+	Rib or vertebral abnormalities may be seen	Abnormality that may be causing the deformity Enlargement of the central canal of the spinal cord	MRI	Impaired ambulation and loss of penile erection when syrinx involves lumbosacral area
Scoliosis	+	+/-	+/-	+/-	+/-	+/-	Rib or vertebral abnormalities usually seen	Abnormality that may be causing the deformity Spinal cord abnormalities may be seen	MRI	EMG and nerve conduction testing: evidence of upper motor neuron lesions.
Leg length discrepancy	+	-	-	-	-	-	Quantify the degree of leg-length discrepancy.	None	Orthoroentogram	Repeat standing x-rays with the patient standing on a block to account for the discrepancy demonstrates correction of the postural abnormality.

References

↑ Meyer SH, Morris GF, Pretorius DH, James HE (March 1998). "Terminal myelocystocele: important differential diagnosis in the prenatal assessment of spina bifida". J Ultrasound Med. 17 (3): 193–7. PMID 9514174.
↑ Scott RM, Wolpert SM, Bartoshesky LE, Zimbler S, Karlin L (April 1988). "Segmental spinal dysgenesis". Neurosurgery. 22 (4): 739–44. PMID 3374785.
↑ Kremser E, Mitchell GM (February 1971). "Treatment of primary dysmenorrhea with a combined type oral contraceptive--a double blind study". J Am Coll Health Assoc. 19 (3): 195–6. PMID 4925436.
↑ Benedetti-Valentino F J, De Feo V, Pistolese GR, Fiorani P (September 1966). "[Nephroptosis and fibromuscular hyperplasia of the tunica media of the renal arteries]". Minerva Cardioangiol (in Italian). 14 (9): 528–34. PMID 5991006. Vancouver style error: name (help)
↑ Naccarato R, Sturniolo GC, Martin A, D'Odorico A, Montino C (March 1988). "[Irritable bowel syndrome]". G Clin Med (in Italian). 69 (3): 163–8. PMID 3169446.
↑ Calloni SF, Huisman TA, Poretti A, Soares BP (2017). "Back pain and scoliosis in children: When to image, what to consider". Neuroradiol J. 30 (5): 393–404. doi:10.1177/1971400917697503. PMC 5602330. PMID 28786774.
↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.

Template:WH Template:WS

[pmid9514174-1] Meyer SH, Morris GF, Pretorius DH, James HE (March 1998). "Terminal myelocystocele: important differential diagnosis in the prenatal assessment of spina bifida". J Ultrasound Med. 17 (3): 193–7. PMID 9514174.

[pmid3374785-2] Scott RM, Wolpert SM, Bartoshesky LE, Zimbler S, Karlin L (April 1988). "Segmental spinal dysgenesis". Neurosurgery. 22 (4): 739–44. PMID 3374785.

[pmid4925436-3] Kremser E, Mitchell GM (February 1971). "Treatment of primary dysmenorrhea with a combined type oral contraceptive--a double blind study". J Am Coll Health Assoc. 19 (3): 195–6. PMID 4925436.

[pmid5991006-4] Benedetti-Valentino F J, De Feo V, Pistolese GR, Fiorani P (September 1966). "[Nephroptosis and fibromuscular hyperplasia of the tunica media of the renal arteries]". Minerva Cardioangiol (in Italian). 14 (9): 528–34. PMID 5991006. Vancouver style error: name (help)

[pmid3169446-5] Naccarato R, Sturniolo GC, Martin A, D'Odorico A, Montino C (March 1988). "[Irritable bowel syndrome]". G Clin Med (in Italian). 69 (3): 163–8. PMID 3169446.

[pmid28786774-6] Calloni SF, Huisman TA, Poretti A, Soares BP (2017). "Back pain and scoliosis in children: When to image, what to consider". Neuroradiol J. 30 (5): 393–404. doi:10.1177/1971400917697503. PMC 5602330. PMID 28786774.

[7] Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.

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@@ Line 14: / Line 14: @@
 ==Differentiating Scoliosis from other Diseases==
-*Spina bifida must be differentiated from other diseases that causes vertebral column defects, [[spinal deformity]], [[neurologic]] abnormalities and [[gait]] abnormalities, such as [[Arnold-Chiari malformation|arnold-chiari malformation]], [[syringomyelia]], [[Scoliosis]],  and [[leg length discrepancy]].<ref name="pmid28786774">{{cite journal| author=Calloni SF, Huisman TA, Poretti A, Soares BP| title=Back pain and scoliosis in children: When to image, what to consider. | journal=Neuroradiol J | year= 2017 | volume= 30 | issue= 5 | pages= 393-404 | pmid=28786774 | doi=10.1177/1971400917697503 | pmc=5602330 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28786774  }} </ref><ref>Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.</ref>
+*Spina bifida must be differentiated from other diseases that causes vertebral column defects, [[spinal deformity]] and [[neurologic]] abnormalities or [[gait]] abnormalities, such as [[Arnold-Chiari malformation|arnold-chiari malformation]], [[syringomyelia]], [[Scoliosis]],  and [[leg length discrepancy]].<ref name="pmid28786774">{{cite journal| author=Calloni SF, Huisman TA, Poretti A, Soares BP| title=Back pain and scoliosis in children: When to image, what to consider. | journal=Neuroradiol J | year= 2017 | volume= 30 | issue= 5 | pages= 393-404 | pmid=28786774 | doi=10.1177/1971400917697503 | pmc=5602330 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28786774  }} </ref><ref>Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.</ref>
 {|
@@ Line 39: / Line 39: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |M.R.I.
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Scoliosis]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Spina bifida]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +/-
@@ Line 47: / Line 47: @@
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Rib]] or [[Vertebra|vertebral]] abnormalities usually seen
+* Incomplete union of the posterior elements of [[Vertebra|vertebral]] levels
+| style="background: #F5F5F5; padding: 5px;" |
+* Various degrees of failure of [[Neural tube defect|neural tube]] closure
+* Posterior sac contains [[meninges]] and/or [[spinal cord]]
+| style="background: #F5F5F5; padding: 5px;" |[[MRI]]
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Swelling (medical)|Swelling]] on the back
+* Tuft of hair
+|-
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arnold-Chiari malformation|Arnold-chiari malformation]]
+| style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" |None
 | style="background: #F5F5F5; padding: 5px;" |
-* Abnormality that may be causing the deformity
+* [[Tethered spinal cord syndrome|Tethered spinal cord]]
-* [[Spinal cord]] abnormalities may be seen
+* [[Brain herniation|Tonsillar herniation]]
 | style="background: #F5F5F5; padding: 5px;" |[[MRI]]
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Electromyography|EMG]] and [[Nerve conduction study|nerve conduction]] testing: evidence of [[Upper motor neuron|upper motor neuron lesions]].
+* [[Headache]]
+* Absent [[gag reflex]]
+*
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Syringomyelia]]
@@ Line 71: / Line 89: @@
 * Impaired ambulation and loss of penile erection when [[Syrinx (medicine)|syrinx]] involves lumbosacral area
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Spina bifida]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Scoliosis]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +/-
@@ Line 79: / Line 97: @@
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" |
-* Incomplete union of the posterior elements of [[Vertebra|vertebral]] levels
+* [[Rib]] or [[Vertebra|vertebral]] abnormalities usually seen
 | style="background: #F5F5F5; padding: 5px;" |
-* Various degrees of failure of [[Neural tube defect|neural tube]] closure
+* Abnormality that may be causing the deformity
-* Posterior sac contains [[meninges]] and/or [[spinal cord]]
+* [[Spinal cord]] abnormalities may be seen
 | style="background: #F5F5F5; padding: 5px;" |[[MRI]]
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Swelling (medical)|Swelling]] on the back
+* [[Electromyography|EMG]] and [[Nerve conduction study|nerve conduction]] testing: evidence of [[Upper motor neuron|upper motor neuron lesions]].
-* Tuft of hair
-|-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Arnold-chiari malformation
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |None
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Tethered spinal cord syndrome|Tethered spinal cord]]
-* [[Brain herniation|Tonsillar herniation]]
-| style="background: #F5F5F5; padding: 5px;" |[[MRI]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Headache]]
-* Absent [[gag reflex]]
-*
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Leg length discrepancy]]

Spina bifida differential diagnosis: Difference between revisions

Revision as of 18:26, 25 January 2019

Overview

Differentiating [Disease name] from other Diseases

Differentiating Scoliosis from other Diseases

References

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