Hysterical Scoliosis

Hysterical scoliosis is a diagnosis of exclusion.

[5,534,710]
The curvature generally has a long C-shaped appearance,
with trunk imbalance, lack of abnormal neurologic or other physical findings, and no radiographic evidence of
vertebral rotation. There may be a change in the pattern or severity of the scoliosis from day to day. The curve
generally resolves when the individual is supine.
A thorough neurologic evaluation is necessary to rule out rare causes, such as spinal cord tumor. Bone scanning
and MRI may be necessary for confirmation. Laboratory studies (complete blood cell count with differential and
sedimentation rate) can rule out infection. Once organic causes have been ruled out, the treatment for hysterical
scoliosis requires psychological (or psychiatric) therapy. Orthotic management should not be undertaken because it
may reinforce the underlying personality disorder.
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