title: Left-right upper arm length asymmetry associated with apical vertebral rotation in subjects with thoracic scoliosis: anomaly of bilateral symmetry affecting vertebral, costal and upper arm physes?
abstract: Left-right skeletal length asymmetries in upper limbs related to curve side and severity have been detected with adolescent idiopathic scoliosis (AIS). This paper reports upper arm length asymmetry in thoracic scoliosis related significantly to apical vertebral rotation in school screening referrals. The reason(s) for the association of upper arm length asymmetry with apical vertebral rotation is unknown and three factors are considered: (1) neuromuscular mechanisms from primary or secondary causes, (2) relative concave neurocentral synchondrosis overgrowth, and (3) relative concave periapical rib length overgrowth, A putative anomaly of growth plates (physes) of ribs, neurocentral synchondroses and upper arms, would account for the findings. A solution to this dilemma may emerge from the results of surgery should concave periapical rib resections become evaluated further for right thoracic AIS in girls.
authors.affiliation: The Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, UK.
authors.forename: R G
authors.initials: RG
authors.lastname: Burwell
authors.forename: B J C
authors.initials: BJ
authors.lastname: Freeman
authors.forename: P H
authors.initials: PH
authors.lastname: Dangerfield
authors.forename: R K
authors.initials: RK
authors.lastname: Aujla
authors.forename: A A
authors.initials: AA
authors.lastname: Cole
authors.forename: A S
authors.initials: AS
authors.lastname: Kirby
authors.forename: R K
authors.initials: RK
authors.lastname: Pratt
authors.forename: J K
authors.initials: JK
authors.lastname: Webb
authors.forename: A
authors.initials: A
authors.lastname: Moulton
mesh_terms: D000293:Adolescent; D001132:Arm / Q000254:growth & development*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012399:Rotation; D012600:Scoliosis / Q000503:physiopathology*; D013904:Thoracic Vertebrae / Q000503:physiopathology*; D006113:United Kingdom