AP radiograph of the lumbar spine (left) demonstrates a curvature of the thoracolumbar spine convex to the left caused by a fusion of the right sided pedicles of the L1 and L2 vertebral bodies which is better demonstrated on the tomographic image (right).CXR AP shows a round soft tissue density in the superior and medial aspect of the right hemithorax which was found on cross sectional imaging to be in the posterior mediastinum, along with multiple hemivertebra segmentation anomalies of the lower cervical and upper thoracic spine causing a curvature of the upper thoracic spine convex to the right.CXR AP shows multiple left-sided anterior and multiple right-sided posterior rib fusions and a mild curvature of the spine convex left resulting in a small thorax.CXR AP (left) shows the right hemithorax to be smaller than the left hemithorax and there is opacity in the right upper and middle lobes and an aerated right lower lobe. There are multiple hemivertebrae and a butterfly vertebra in the thoracic spine causing a scoliosis convex left. Axial CT with contrast of the chest (above right) shows the right pulmonary artery to be absent along with the right upper lobe. Axial CT (below right) shows absence of the right middle lobe of the lung but the right lower lobe of the lung is present and aerated via a small bronchus off of the trachea (not shown) and perfused by collateral vessels arising from the 7 o’clock position off of the aorta.
Radiology Cases of Congenital Scoliosis in VACTERL Syndrome
CXR AP (left) shows a hemivertebra at L1 causing spinal curvature convex left. Transverse US of the pelvis (above right) shows in the midline anteriorly an anechoic fluid-filled bladder with a round echogenic stool-filled rectum posterior to it while a transverse US of the perineum (below right) shows a very short distance between the calipers superiorly on the skin and inferiorly on the anterior wall of the rectum.
Radiology Cases of Congenital Scoliosis Due to Spondylothoracic Dysostosis
AP and lateral radiographs of the spine show multiple vertebral body anomalies throughout the spine including butterfly vertebrae, hemivertebrae, fused vertebrae and hypoplastic vertebrae. There are also multiple levels of rib fusion present posteriorly.
