Presentation
Known congenital neuromuscular disorder.Presents for ventriculoperitoneal shunt integrity, kyphoscoliosis, and coxa valga assessment.
Patient Data
Intact visualized ventriculoperitoneal shunt. There is a gentle thoraco-lumbar levoscoliosis. There is a pelvic tilt and evidence of coxa valga. The femoral neck-shaft angle measures 163.5o on the right and 170.3o on the left, both greater than 140o, consistent with coxa valga.
Case Discussion
An unusual curled appearance of the intact ventriculoperitoneal shunt within the lower abdomen. The curling is of questionable significance, as the shunt is likely patent with satisfactory drainage on clinical assessment and previous CT and MRI brain studies.
The postural scoliosis is mild with a measured Cobb's angle of 6.9o.
There is a pelvic tilt, with the right pelvis slightly higher than the left.
There is bilateral coxa valga as measured by the angle between the femoral neck and shaft. This may be exaggerated due to the femoral anteversion and rotation in these patients with congenital neuromuscular disorders which may partially explain the increased angles in this instance.