Lateral curvature of the spine and round shoulders . of congenital scoliosisso far formulated. 2. JNIALFORMATIONS OF THESCAPULA Congenital elevation of thescapula (Sprengels deformity)will cause a scoliosis which isusually a high cervicodorsalcurve with compensating dor-solumbar curve. One scapulais occasionally absent or mal-formed (Fig. 73). 3. malfor:\iation of the THORAX Occasionally great irregu-larity characterizes the ribs ofone or both sides. Some maybe bifurcated, others are Unitedby a bridge of bone, while inothers certain ribs are missing,scoliosis. Heredity must also be considered,
Lateral curvature of the spine and round shoulders . of congenital scoliosisso far formulated. 2. JNIALFORMATIONS OF THESCAPULA Congenital elevation of thescapula (Sprengels deformity)will cause a scoliosis which isusually a high cervicodorsalcurve with compensating dor-solumbar curve. One scapulais occasionally absent or mal-formed (Fig. 73). 3. malfor:\iation of the THORAX Occasionally great irregu-larity characterizes the ribs ofone or both sides. Some maybe bifurcated, others are Unitedby a bridge of bone, while inothers certain ribs are missing,scoliosis. Heredity must also be considered, as it is known that scoliosis isapparently inherited in some families, Schulthess estimating thatfrom 10 to 15 per cent, of scolioses are hereditary. Congenitaldefects of form can be inherited, and would reasonably lead to similarforms of scoliosis, while an inherited weak skeleton or a disposition torickets would not necessarily lead to a reproduction of the form ofscoliosis. There are cases, however, in which the form also seems tobe Fig. 73.—Congenital Elevation of theScapula Causing Scoliosis. Such irregularities are a cause of Boston Med. and Surg. Jour., Apr. 28, 1910. ETIOLOGY B. ACQUIRED SCOLIOSIS Scoliosis is to be classed as acquired when the deformity comes onafter birth from some cause not apparently congenital, and thisincludes, so far as we know now, the greater number of cases. Theexperimental production of scoliosis in animals has been demon-strated and is discussed elsewhere (page 48). The acquired varietiesof scoliosis may be considered as follows: I. ANATOMICAL OR PHYSIOLOGICAL ASYMMETRIES ELSEWHERETHAN IN THE SPINE (a) Torticollis,—or wry-neck, a condition characterized by the con-traction of one sternocleidomastoid muscle, causes a tilted andtwisted position of the head and necessitates a compensatory lateralcurve of the spine to preserve the balance and enable the head toassume a more normal position. Unilateral torticollis, if suffi
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