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Vertebral wedging

MedGen UID:
120495
Concept ID:
C0264112
Anatomical Abnormality
Synonyms: Wedge-shaped vertebrae; Wedged vertebrae
SNOMED CT: Wedging of vertebra (19888007)
 
HPO: HP:0008422

Definition

An abnormal shape of the vertebral bodies whereby the vertebral bodies are thick on one side and taper to a thin edge at the other. [from HPO]

Conditions with this feature

Gorlin syndrome
MedGen UID:
2554
Concept ID:
C0004779
Neoplastic Process
Nevoid basal cell carcinoma syndrome (NBCCS) is characterized by the development of multiple jaw keratocysts, frequently beginning in the second decade of life, and/or basal cell carcinomas (BCCs) usually from the third decade onward. Approximately 60% of individuals have a recognizable appearance with macrocephaly, frontal bossing, coarse facial features, and facial milia. Most individuals have skeletal anomalies (e.g., bifid ribs, wedge-shaped vertebrae). Ectopic calcification, particularly in the falx, is present in more than 90% of affected individuals by age 20 years. Cardiac and ovarian fibromas occur in approximately 2% and 20% of individuals respectively. Approximately 5% of all children with NBCCS develop medulloblastoma (primitive neuroectodermal tumor), generally the desmoplastic subtype. The risk of developing medulloblastoma is substantially higher in individuals with an SUFU pathogenic variant (33%) than in those with a PTCH1 pathogenic variant (<2%). Peak incidence is at age one to two years. Life expectancy in NBCCS is not significantly different from average.
Bruck syndrome 1
MedGen UID:
342431
Concept ID:
C1850168
Disease or Syndrome
Bruck syndrome-1 (BRKS1) is characterized by congenital contractures with pterygia, onset of fractures in infancy or early childhood, postnatal short stature, severe limb deformity, and progressive scoliosis (McPherson and Clemens, 1997). Genetic Heterogeneity of Bruck Syndrome Bruck syndrome-2 (BRKS2; 609220) is caused by homozygous mutation in the PLOD2 gene (601865) on chromosome 3q24. Van der Slot et al. (2003) stated that they were unaware of any phenotypic differences between the 2 forms of Bruck syndrome.
Richieri Costa-da Silva syndrome
MedGen UID:
419686
Concept ID:
C2930978
Disease or Syndrome
A rare genetic myotonic syndrome characterised by childhood onset of progressive and severe myotonia (with generalised muscular hypertrophy and progressive impairment of gait) short stature, skeletal abnormalities (including pectus carinatum, short, wedge-shaped thoracolumbar vertebrae, kyphoscoliosis, genu valgum, irregular femoral epiphyses) and mild to moderate intellectual deficiency. Facial dysmorphism and joint limitation are not associated. There have been no further descriptions in the literature since 1984.
Osteogenesis imperfecta type 5
MedGen UID:
419332
Concept ID:
C2931093
Disease or Syndrome
Osteogenesis imperfecta (OI) is a connective tissue disorder characterized by bone fragility and low bone mass. Due to considerable phenotypic variability, Sillence et al. (1979) developed a classification of OI subtypes based on clinical features and disease severity: OI type I, with blue sclerae (166200); perinatal lethal OI type II, also known as congenital OI (166210); OI type III, a progressively deforming form with normal sclerae (259420); and OI type IV, with normal sclerae (166220). Most forms of OI are autosomal dominant with mutations in one of the 2 genes that code for type I collagen alpha chains, COL1A1 (120150) and COL1A2 (120160). Glorieux et al. (2000) described a novel autosomal dominant form of OI, which they designated OI type V (OI5), in 7 patients. The disorder was similar to OI type IV but had distinctive clinical, histologic, and molecular characteristics. OI type V is characterized by calcification of the forearm interosseous membrane, radial head dislocation, a subphyseal metaphyseal radiodense line, and hyperplastic callus formation (summary by Cho et al., 2012). OI type V has a variable phenotype. For example, in patients with the more common c.-14C-T variant (614757.0001), distinctive radiographic findings (calcification of the forearm interosseous membrane, radial head dislocation, a subphyseal metaphyseal radiodense line, and hyperplastic callus formation) are often seen, whereas these findings are not seen in patients with the less common S40L variant (614757.0002).
Osteogenesis imperfecta type 11
MedGen UID:
462568
Concept ID:
C3151218
Disease or Syndrome
Osteogenesis imperfecta (OI) comprises a group of connective tissue disorders characterized by bone fragility and low bone mass. The disorder is clinically and genetically heterogeneous. OI type XI is an autosomal recessive form of OI (summary by Alanay et al., 2010).
Spondyloepiphyseal dysplasia, Stanescu type
MedGen UID:
905084
Concept ID:
C4225273
Disease or Syndrome
Spondyloepiphyseal dysplasia with accumulation of glycoprotein in chondrocytes has been designated the 'Stanescu type.' Clinical hallmarks include progressive joint contracture with premature degenerative joint disease, particularly in the knee, hip, and finger joints. Interphalangeal joints of the hands are swollen due to osseous distention of the metaphyseal ends of the phalanges. Affected individuals may be relatively tall despite the presence of a short trunk. Radiologically, there is generalized platyspondyly with mild modification of the endplates, hypoplastic pelvis, epiphyseal flattening with metaphyseal splaying of the long bones, and enlarged phalangeal epimetaphyses of the hands. In addition, the proximal femora are characteristically broad and elongated with striking coxa valga (summary by Nishimura et al., 1998).
Epiphyseal dysplasia, multiple, 7
MedGen UID:
1620874
Concept ID:
C4540251
Disease or Syndrome
Short-rib thoracic dysplasia 18 with polydactyly
MedGen UID:
1632904
Concept ID:
C4693420
Disease or Syndrome
Short-rib thoracic dysplasia (SRTD) with or without polydactyly refers to a group of autosomal recessive skeletal ciliopathies that are characterized by a constricted thoracic cage, short ribs, shortened tubular bones, and a 'trident' appearance of the acetabular roof. SRTD encompasses Ellis-van Creveld syndrome (EVC) and the disorders previously designated as Jeune syndrome or asphyxiating thoracic dystrophy (ATD), short rib-polydactyly syndrome (SRPS), and Mainzer-Saldino syndrome (MZSDS). Polydactyly is variably present, and there is phenotypic overlap in the various forms of SRTDs, which differ by visceral malformation and metaphyseal appearance. Nonskeletal involvement can include cleft lip/palate as well as anomalies of major organs such as the brain, eye, heart, kidneys, liver, pancreas, intestines, and genitalia. Some forms of SRTD are lethal in the neonatal period due to respiratory insufficiency secondary to a severely restricted thoracic cage, whereas others are compatible with life (summary by Huber and Cormier-Daire, 2012 and Schmidts et al., 2013). There is phenotypic overlap with the cranioectodermal dysplasias (Sensenbrenner syndrome; see CED1, 218330). For a discussion of genetic heterogeneity of short-rib thoracic dysplasia with or without polydactyly, see SRTD1 (208500).
Osteogenesis imperfecta, type 19
MedGen UID:
1648353
Concept ID:
C4746956
Disease or Syndrome
Osteogenesis imperfecta type XIX (OI19) is characterized by prenatal fractures and generalized osteopenia, with severe short stature in adulthood, as well as variable scoliosis and pectal deformity, and marked anterior angulation of the tibia (Lindert et al., 2016).

Professional guidelines

PubMed

Simm PJ, Johannesen J, Briody J, McQuade M, Hsu B, Bridge C, Little DG, Cowell CT, Munns CF
Bone 2011 Nov;49(5):939-43. Epub 2011 Jul 28 doi: 10.1016/j.bone.2011.07.031. PMID: 21820091
Aronsson DD, Stokes IA
J Pediatr Orthop 2011 Jan-Feb;31(1 Suppl):S99-106. doi: 10.1097/BPO.0b013e318203b141. PMID: 21173627Free PMC Article
Montgomery SP, Erwin WE
Spine (Phila Pa 1976) 1981 Jan-Feb;6(1):5-8. doi: 10.1097/00007632-198101000-00002. PMID: 6782681

Recent clinical studies

Etiology

Cheung WK, Cheung JPY
BMC Musculoskelet Disord 2022 Oct 10;23(1):904. doi: 10.1186/s12891-022-05863-z. PMID: 36217198Free PMC Article
Wang S, Xu L, Wang M, Qiu Y, Zhu Z, Wang B, Sun X
J Neurosurg Spine 2021 Jul 30;35(4):486-494. doi: 10.3171/2021.1.SPINE202086. PMID: 34330099
Hershkovich O, D'Souza A, Rushton PRP, Onosi IS, Yoon WW, Grevitt MP
Bone Joint J 2020 Apr;102-B(4):513-518. doi: 10.1302/0301-620X.102B4.BJJ-2019-1069.R1. PMID: 32228067
Palazzo C, Sailhan F, Revel M
Joint Bone Spine 2014 May;81(3):209-14. Epub 2014 Jan 24 doi: 10.1016/j.jbspin.2013.11.012. PMID: 24468666
Tsirikos AI, Jain AK
J Bone Joint Surg Br 2011 Jul;93(7):857-64. doi: 10.1302/0301-620X.93B7.26129. PMID: 21705553

Diagnosis

Yu SH, Ng CM, Cheung JP, Shea GK
J Bone Joint Surg Am 2023 Feb 15;105(4):277-285. Epub 2023 Jan 23 doi: 10.2106/JBJS.22.00939. PMID: 36689574
Yildiz HK, Ekin EE
J Back Musculoskelet Rehabil 2017 Sep 22;30(5):1061-1067. doi: 10.3233/BMR-169666. PMID: 28505960
Begon M, Scherrer SA, Coillard C, Rivard CH, Allard P
Spine J 2015 Mar 1;15(3):477-86. Epub 2014 Oct 13 doi: 10.1016/j.spinee.2014.10.004. PMID: 25463399
Palazzo C, Sailhan F, Revel M
Joint Bone Spine 2014 May;81(3):209-14. Epub 2014 Jan 24 doi: 10.1016/j.jbspin.2013.11.012. PMID: 24468666
Tsirikos AI, Jain AK
J Bone Joint Surg Br 2011 Jul;93(7):857-64. doi: 10.1302/0301-620X.93B7.26129. PMID: 21705553

Therapy

Photopoulos G, Hurry J, Murphy J, Brooks J, Fitzgerald R, Louer C, Shaw K, Smit K, Miyanji F, Parent S; Pediatric Spine Study Group, El-Hawary R
Spine Deform 2023 Jan;11(1):115-121. Epub 2022 Aug 23 doi: 10.1007/s43390-022-00570-0. PMID: 35997944
Ooi HL, Briody J, Biggin A, Cowell CT, Munns CF
Horm Res Paediatr 2013;80(3):179-84. Epub 2013 Sep 18 doi: 10.1159/000354303. PMID: 24052046
Tsirikos AI, Jain AK
J Bone Joint Surg Br 2011 Jul;93(7):857-64. doi: 10.1302/0301-620X.93B7.26129. PMID: 21705553
Aronsson DD, Stokes IA
J Pediatr Orthop 2011 Jan-Feb;31(1 Suppl):S99-106. doi: 10.1097/BPO.0b013e318203b141. PMID: 21173627Free PMC Article
Bradford DS
Clin Orthop Relat Res 1977 Oct;(128):45-55. PMID: 598175

Prognosis

Zheng Y, Zhou J, Niu C, Ye Q, Tang J, Wang X, Wang G
J Orthop Surg Res 2023 Sep 29;18(1):738. doi: 10.1186/s13018-023-04094-9. PMID: 37773144Free PMC Article
Yu SH, Ng CM, Cheung JP, Shea GK
J Bone Joint Surg Am 2023 Feb 15;105(4):277-285. Epub 2023 Jan 23 doi: 10.2106/JBJS.22.00939. PMID: 36689574
Margalit A, McKean G, Lawing C, Galey S, Ain MC
J Pediatr Orthop 2018 Nov/Dec;38(10):491-497. doi: 10.1097/BPO.0000000000000862. PMID: 27636912
Poorghasamians E, Aggabao PC, Wren TAL, Ponrartana S, Gilsanz V
PLoS One 2017;12(12):e0190225. Epub 2017 Dec 27 doi: 10.1371/journal.pone.0190225. PMID: 29281728Free PMC Article
Tsirikos AI, Jain AK
J Bone Joint Surg Br 2011 Jul;93(7):857-64. doi: 10.1302/0301-620X.93B7.26129. PMID: 21705553

Clinical prediction guides

Sowa D, Guzik G, Bronisz M, Merkiel D, Pyrka D, Pyrka Z
Ortop Traumatol Rehabil 2023 Feb 28;25(1):1-8. doi: 10.5604/01.3001.0053.4025. PMID: 38078347
Wang S, Xu L, Wang M, Qiu Y, Zhu Z, Wang B, Sun X
J Neurosurg Spine 2021 Jul 30;35(4):486-494. doi: 10.3171/2021.1.SPINE202086. PMID: 34330099
Bauer JM, Ditro CP, Mackenzie WG
Spine Deform 2019 May;7(3):494-500. doi: 10.1016/j.jspd.2018.09.007. PMID: 31053321
Poorghasamians E, Aggabao PC, Wren TAL, Ponrartana S, Gilsanz V
PLoS One 2017;12(12):e0190225. Epub 2017 Dec 27 doi: 10.1371/journal.pone.0190225. PMID: 29281728Free PMC Article
Tsirikos AI, Jain AK
J Bone Joint Surg Br 2011 Jul;93(7):857-64. doi: 10.1302/0301-620X.93B7.26129. PMID: 21705553

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