A patient has a right shoulder that is higher than the left, and a left iliac crest that is higher than the right. The patient also exhibits a right thoracic rib hump with forward bending of the trunk. Which description BEST fits these findings?

A patient has a right shoulder that is higher than the left, and a left iliac crest that is higher than the right. The patient also exhibits a right thoracic rib hump with forward bending of the trunk. Which description BEST fits these findings?

• A. Left thoracic functional scoliosis
• B. Right thoracic function scoliosis
• C. Left thoracic structural scoliosis
• D. Right thoracic structural scoliosis

Answer: (D)

The key idea is that a rib hump that appears on forward bending shows the spine is rotated and the curve is fixed, not just a temporary posture. A rib hump on the right means the thoracic spine is rotated toward the right, giving a convex right-sided curve in that region. The shoulder is higher on the right and the left iliac crest is higher than the right, which are typical compensatory imbalances you see with a thoracic scoliosis that has rotation: the trunk and pelvis tilt as the spine twists. Because the deformity includes vertebral rotation and remains evident on forward bending, it is a structural scoliosis. Since the right thoracic region is the area involved, the description that fits best is a right thoracic structural scoliosis.

The key idea is that a rib hump that appears on forward bending shows the spine is rotated and the curve is fixed, not just a temporary posture. A rib hump on the right means the thoracic spine is rotated toward the right, giving a convex right-sided curve in that region. The shoulder is higher on the right and the left iliac crest is higher than the right, which are typical compensatory imbalances you see with a thoracic scoliosis that has rotation: the trunk and pelvis tilt as the spine twists. Because the deformity includes vertebral rotation and remains evident on forward bending, it is a structural scoliosis. Since the right thoracic region is the area involved, the description that fits best is a right thoracic structural scoliosis.