Sway back appearance is seen in a child with?

Appeared in: Daman & Diu Staff Nurse - 2018

Explanation

Lordosis is the medical term for an exaggerated inward curvature of the lumbar (lower) spine.
This inward curve pushes the abdomen forward and the buttocks backward, creating a posture commonly described as "sway back.".
While a slight lumbar curve is normal, an excessive curve, known as lordosis or hyperlordosis, is considered a postural deformity.
This condition is often seen in toddlers and can also be associated with obesity or muscle imbalances in older children.

Option A: Talipes, or clubfoot, is a congenital deformity of the foot and ankle. It does not involve the spine and therefore does not cause a 'sway back' appearance.
Option B: Scoliosis is a lateral, or sideways, curvature of the spine. It causes the spine to look like an 'S' or 'C' from the back, leading to uneven shoulders or hips, not a 'sway back' posture.
Option D: Kyphosis is an excessive outward curvature of the thoracic spine, creating a 'hunchback' or rounded back appearance. This is the opposite of the inward curve seen in lordosis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of spinal deformities based on clinical presentation as background academic context rather than a clinical decision trigger.
Nurses play a key role in screening for postural abnormalities during routine pediatric check-ups. Observing a child's posture from the front, back, and side is a fundamental assessment skill.
Early identification of significant spinal deformities like lordosis, kyphosis, or scoliosis is crucial for timely referral to a specialist. Management can range from physical therapy and observation to bracing or surgery.
What if? If a child presents with a 'sway back' posture but can easily flatten their back against the floor when lying down, it is likely a flexible or postural lordosis, which is common and often self-corrects. A rigid, fixed curve is more concerning.

How to Approach the Question

First, identify the key descriptive phrase in the question: "Sway back appearance."
Mentally recall the definitions of the common spinal deformities provided in the options.
Associate "sway back" with an inward curve of the lower back.
Match this description to the correct medical term. Lordosis is the term for the inward curve of the lumbar spine.
Eliminate the other options by defining them: Kyphosis is an outward curve ('hunchback'), Scoliosis is a sideways curve, and Talipes is a foot deformity ('clubfoot').

Concept Tested & Keywords

Concept Tested: Identification of spinal deformities based on clinical presentation.
Stem keywords: Sway back appearance, child
Lead-in keywords: seen in
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Nursing Fundamentals Taylor p. 408-410

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 2054-2056

Practise the full Daman & Diu Staff Nurse - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.