Abstract

HERNANI-EUSEBIO, Jorge; SILVA, Ricardo Jorge  and  MACHADO, Álvaro. Camptocormia: a bizarre case report and how to properly evaluate it. Rev Port Med Geral Fam [online]. 2020, vol.36, n.5, pp.430-435. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i5.12671.

Introduction: Camptocormia (anterior flexion of the thoracic and lumbar column) is a diagnosis secondary to neurological diseases (mostly Parkinson’s disease), orthopedic diseases, and other causes (like pharmacological intoxication and paraneoplastic syndromes). The anterior flexion of the spine due to neurological diseases fully reverses when the patient assumes a supine position. However, that is not observed when camptocormia is due to an orthopedic cause. This finding is particularly important when considering the course of action and proper patient evaluation. Case report: Male, 65 years old, no relevant medical history or usual medication reported. The patient enters the neurology consultation with marked thoracolumbar anterior flexion. Previously oriented by his general practitioner to an orthopedic appointment, with a CT showing a compression fracture of the T12 vertebrae. The patient underwent physiotherapy and was conducted from the physiatry consultation to neurology with the suspicion of an underlying neurological cause of camptocormia. A physical examination we observed an irreversible camptocormia at supine position and absence of tremor, stiffness, or dyskinesia. Urinary incontinence was ruled out. Comments: Camptocormia patients might be complex to evaluate. Therefore, the holistic approach is substantial to fully understand the patient’s symptoms and the primary cause of camptocormia. In our case report, a non-reversible camptocormia at the supine position, the absence of tremor/extrapyramidal symptoms, and CT findings of an orthopedic cause make the evaluation by neurology less important than the one preferred previously by the general practitioner. We find this approach more convenient in order to manage the patient’s expectations regarding the resolution of the problem. The patient gave his free, clarified, and informed consent regarding the collection of clinical data, photography, and the publication of this case report.

Keywords : Spinal curvatures; Spinal curvatures/diagnosis; Spinal curvatures/etiology; Muscular atrophy/diagnosis; Muscular atrophy/etiology; Camptocormia.

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