Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does The CT Scan Result Indicate?
Question: We are mainly interested in having a 3D CT scan reviewed to receive professional advice.
My niece who just turned 4 has a significant abnormality in her left shoulder (it is higher than the other shoulder) since she was born. Initially it was believed that it will go away with time or perhaps one of her siblings had mishandled her. She has been seen by an orthopedic who has said she has "Sprengles deformity" or "Sprengles elevated scapula" and she may need a surgery. While the doctor did not confirm, based on what we researched she may have a grade 3 deformity but we are not sure.
We would like to know how safe is the surgery and what are the possible side effects, where is the best place to have it done? We are also interested to know the costs and how much follow up is needed.
For correct assessment, you will need to review the CT scan that we did recently. The problem is that the file is too large to upload here (150 MB). Below, however, is a public link for you to download the file:
https://dl.dropboxusercontent.com/u/0000/NOOR.iso
Please mention reference to the attached file in your response.
Thanks!
My niece who just turned 4 has a significant abnormality in her left shoulder (it is higher than the other shoulder) since she was born. Initially it was believed that it will go away with time or perhaps one of her siblings had mishandled her. She has been seen by an orthopedic who has said she has "Sprengles deformity" or "Sprengles elevated scapula" and she may need a surgery. While the doctor did not confirm, based on what we researched she may have a grade 3 deformity but we are not sure.
We would like to know how safe is the surgery and what are the possible side effects, where is the best place to have it done? We are also interested to know the costs and how much follow up is needed.
For correct assessment, you will need to review the CT scan that we did recently. The problem is that the file is too large to upload here (150 MB). Below, however, is a public link for you to download the file:
https://dl.dropboxusercontent.com/u/0000/NOOR.iso
Please mention reference to the attached file in your response.
Thanks!
Brief Answer:
still time for physical therapy correction
Detailed Answer:
hi
I have studied your case
Many patients with the Sprengel deformity do not require operative intervention. For those who do require surgery, the aims in the correction of this condition are twofold. First, the cause of the scapular binding must be released. Second, the scapula must be relocated.
The main objectives in performing surgery are to improve the cosmetic appearance and contour of the neck and to improve the scapular function when it is severely impaired. The optimal age for operative intervention is controversial; however, most would recommend that surgery be performed when patients are younger than age 8 years in order to obtain the best surgical result.
The dropbox link is not opening
So trust your treating doctors opinion as he has examined and if discrepancy in scapular position is there,it is there.
Alternatively, you may seek help from a physical therapist as there is 3-4 years time-maybe it may give some benefit by stretching exercises to somewhat relocate the position as soft tissues in children are very flexible at this tender age and lesser corrective surgery may be required then
Best wishes
still time for physical therapy correction
Detailed Answer:
hi
I have studied your case
Many patients with the Sprengel deformity do not require operative intervention. For those who do require surgery, the aims in the correction of this condition are twofold. First, the cause of the scapular binding must be released. Second, the scapula must be relocated.
The main objectives in performing surgery are to improve the cosmetic appearance and contour of the neck and to improve the scapular function when it is severely impaired. The optimal age for operative intervention is controversial; however, most would recommend that surgery be performed when patients are younger than age 8 years in order to obtain the best surgical result.
The dropbox link is not opening
So trust your treating doctors opinion as he has examined and if discrepancy in scapular position is there,it is there.
Alternatively, you may seek help from a physical therapist as there is 3-4 years time-maybe it may give some benefit by stretching exercises to somewhat relocate the position as soft tissues in children are very flexible at this tender age and lesser corrective surgery may be required then
Best wishes
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks for the response. I would, however, really like it if you could please try opening the dropbox link. Let's try the following if possible:
1. Type https://dl.dropboxusercontent.com/u/0000/NOOR.iso in your browser
2. You should be prompted to either open or save the file. Please click save file and it will take a few minutes to download.
3. Once downloaded, you should be able to open the file with a free software named virtual clone drive (http://www.slysoft.com/en/download.html).
Thanks so much!!
1. Type https://dl.dropboxusercontent.com/u/0000/NOOR.iso in your browser
2. You should be prompted to either open or save the file. Please click save file and it will take a few minutes to download.
3. Once downloaded, you should be able to open the file with a free software named virtual clone drive (http://www.slysoft.com/en/download.html).
Thanks so much!!
Brief Answer:
clinician and radiologist final say, download try being made..
Detailed Answer:
Thank you for the link.I will try again.
Meanwhile if you can attach written report, it would be worthwhile also.3D ct scan is best analysed by the radiologist who is trained in its dimensions, clinicians have to take their objective finding as a final report.A clinical finding is more actual as one can measure the actual position, the flexibility of scapular ligaments ,mobility etc and its anatomical location.This helps to plan the treatment.Scans provide the adjoining tissues position,fibrosis,lengethening or shortening,contracture, any internal attachments and aid in planning type of surgery like osteotomy,,trimming of bone required in upper medial border and clavicular (collar bone) restructuring or correction to make functional ligaments and attachmentsand so would be of more value to a surgeon who will decide the type of surgical steps required.
However, I shall write my assessment as per my knowledge shall allow me.
In my opinion, final word has to be the clinician and the concerned radiologist
I shall get back to you in few hours if it downloads correctly
regards,
clinician and radiologist final say, download try being made..
Detailed Answer:
Thank you for the link.I will try again.
Meanwhile if you can attach written report, it would be worthwhile also.3D ct scan is best analysed by the radiologist who is trained in its dimensions, clinicians have to take their objective finding as a final report.A clinical finding is more actual as one can measure the actual position, the flexibility of scapular ligaments ,mobility etc and its anatomical location.This helps to plan the treatment.Scans provide the adjoining tissues position,fibrosis,lengethening or shortening,contracture, any internal attachments and aid in planning type of surgery like osteotomy,,trimming of bone required in upper medial border and clavicular (collar bone) restructuring or correction to make functional ligaments and attachmentsand so would be of more value to a surgeon who will decide the type of surgical steps required.
However, I shall write my assessment as per my knowledge shall allow me.
In my opinion, final word has to be the clinician and the concerned radiologist
I shall get back to you in few hours if it downloads correctly
regards,
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Here is an alternate option to download the software:
http://virtual-clonedrive.en.lo4d.com/download
Thanks
http://virtual-clonedrive.en.lo4d.com/download
Thanks
Brief Answer:
link doesnt open on my browser
Detailed Answer:
thanks for sending link. I tried many times but link doesnt open on my browser. I will suggest you to write the summary part of the reports instead. You can also send the reports at YYYY@YYYY and address it to my name: Dr. Sunil Kumar Srivastava
Regards,
link doesnt open on my browser
Detailed Answer:
thanks for sending link. I tried many times but link doesnt open on my browser. I will suggest you to write the summary part of the reports instead. You can also send the reports at YYYY@YYYY and address it to my name: Dr. Sunil Kumar Srivastava
Regards,
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for trying to open the link. Let's try the following as I have uploaded selected images to a public location, which you should be able to view easily and without having to download any software:
https://plus.google.com/photos/0000/albums/0000?authkey=CJaurZLf0_zLwgE
Thanks.
https://plus.google.com/photos/0000/albums/0000?authkey=CJaurZLf0_zLwgE
Thanks.
Brief Answer:
For images, Referring to radiologists on forum, basic opinio formed is surg
Detailed Answer:
Thank you for the photo album which I could see.
From the photos it is evident tthat scapula is not only elevated but tilted as well in both axis.The clavicle end at acromion is also far from acromion abutting somewhere in middle of spinous process.The inner border is tilted up.
This, in my opinion, as logically evident from photos, cannot be corrected on its own and definitely both resection of scapula on inner upper side and reconstruction for acromio clavicular joint restoration,release of soft tissues, ligaments etc are required, which , an experienced surgeon may handle, and earlier the better so that permanent contractures may not form, at younger age tissues are still more flexible to correct.
As I wrote earlier, the 3D scan by an expert who does it will be able to give an accurate view of the pictures.
I will request this HCM forum to kindly refer your photo link to Radiologists on the HCM forum to be able to give better opinion on the images
I am opining only what I could see and understand and not from proffessional experience.
Although, being an orthopedics doctor, I have an understanding of basic normal anatomy on images n the basis of which I would want to to do corrective surgery at the eariest
Regards,
For images, Referring to radiologists on forum, basic opinio formed is surg
Detailed Answer:
Thank you for the photo album which I could see.
From the photos it is evident tthat scapula is not only elevated but tilted as well in both axis.The clavicle end at acromion is also far from acromion abutting somewhere in middle of spinous process.The inner border is tilted up.
This, in my opinion, as logically evident from photos, cannot be corrected on its own and definitely both resection of scapula on inner upper side and reconstruction for acromio clavicular joint restoration,release of soft tissues, ligaments etc are required, which , an experienced surgeon may handle, and earlier the better so that permanent contractures may not form, at younger age tissues are still more flexible to correct.
As I wrote earlier, the 3D scan by an expert who does it will be able to give an accurate view of the pictures.
I will request this HCM forum to kindly refer your photo link to Radiologists on the HCM forum to be able to give better opinion on the images
I am opining only what I could see and understand and not from proffessional experience.
Although, being an orthopedics doctor, I have an understanding of basic normal anatomy on images n the basis of which I would want to to do corrective surgery at the eariest
Regards,
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
