title: Prevalence and incidence of scoliosis in Turner syndrome: a study in 49 girls followed-up for 4 years.
abstract: BACKGROUND
  Turner syndrome (TS) is a sex chromosome abnormality in females characterized by gonadal dysgenesis, short stature and skeletal malformations like kyphosis and scoliosis.
  
  
  OBJECTIVE
  To evaluate the prevalence of scoliosis and its incidence over 4 year follow-up.
  
  
  METHODS
  Consists in two parts: cross sectional study and longitudinal study.
  
  
  METHODS
  Outpatient.
  
  
  METHODS
  Forty-nine TS assessed at the Pediatric Outpatients Clinic.
  
  
  METHODS
  Clinical and radiological evaluation of spine.
  
  
  RESULTS
  Cross sectional study: at baseline an high prevalence of minor scoliosis was observed (59%, 95% CI 44-73). The prevalence increased with age (trend test P=0.01). Patients with scoliosis were more frequently on GH therapy (69% vs. 35%, P=0.023). At multivariable analysis (including age, height and GH therapy), height was the only independent correlate of scoliosis. Longitudinal study: of the 20 cases without scoliosis at baseline, 9 were diagnosed with new scoliosis (classified as minor ) after 4 years (incidence of 45% , 95% CI 23-68). We didn't found any predictor of new scoliosis; patients who developed scoliosis 4 years later were older and taller at baseline.
  
  
  CONCLUSIONS
  TS have a higher risk to develop scoliosis and the age at risk is protracted further with respect to normal subjects. This risk appears influenced by the height of the patient and, indirectly, by the GH therapy. Clinical rehabilitation impact. In TS is necessary a prolonged time of observation (until age twenty) for identifying scoliosis and beginning a rehabilitation program.
authors.affiliation: Rehabilitation Unit, Department of Services and Diagnostic Medicine, Policlinico San Matteo-Pavia IRCCS Foundation, University of Pavia, Pavia, Italy. s.ricotti@smatteo.pv.it
authors.forename: S
authors.initials: S
authors.lastname: Ricotti
authors.forename: L
authors.initials: L
authors.lastname: Petrucci
authors.forename: G
authors.initials: G
authors.lastname: Carenzio
authors.forename: C
authors.initials: C
authors.lastname: Klersy
authors.forename: V
authors.initials: V
authors.lastname: Calcaterra
authors.forename: D
authors.initials: D
authors.lastname: Larizza
authors.forename: E
authors.initials: E
authors.lastname: Dalla Toffola
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D007621:Karyotyping; D016014:Linear Models; D008137:Longitudinal Studies; D015995:Prevalence; D012600:Scoliosis / Q000453:epidemiology*; D018709:Statistics, Nonparametric; D014424:Turner Syndrome / Q000453:epidemiology*