Incidence and outcome of scoliosis in children with pleural infection.
OBJECTIVE
To ascertain the incidence and outcome of secondary scoliosis associated with parapneumonic effusions/empyema.


METHODS
Retrospective review of case notes of children with pleural effusions over a 3-year period. Review of digitalized erect chest radiographs by two observers with serial measurements of Cobb angles. Scoliosis defined as lateral curvature of the spine > or = 10 degrees.


RESULTS
Of 122 children (median age 4.3 years), 103 (84%) required chest drains of whom 83/103 (81%) received urokinase; 5 (4%) required surgical decortication. On admission, 56 (46%) had a scoliosis, 68 (62%) on the 2nd radiograph, and 68 (59%) at discharge; overall 87 (71%) had a scoliosis at some stage. In all cases, there was a single thoracic curve with the direction towards the side of the effusion. There was no association between scoliosis and size or type of effusion, nor inflammatory markers. There was a statistically significant but small effect from duration of illness prior to admission. At follow-up, 6 (5%) had a mild residual scoliosis but all subsequently resolved. Intraobserver variability for measurement of Cobb angles was +/-4.6 degrees and interobserver variability was +/-5.8 degrees.


CONCLUSIONS
Scoliosis was common but always resolved so therapy is unnecessary; follow up is recommended to exclude coincidental idiopathic scoliosis.
Mukherjee
S
S
Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom.
Langroudi
B
B
Rosenthal
M
M
Balfour-Lynn
I M
IM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016724:Empyema, Pleural / Q000150:complications; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010996:Pleural Effusion / Q000150:complications; D011379:Prognosis; D012141:Respiratory Tract Infections / Q000150:complications*; D012189:Retrospective Studies; D012600:Scoliosis / Q000453:epidemiology* / Q000209:etiology*