Clinical Images  |   July 2020
Straight Back Syndrome
Author Notes
• From the University of Florida College of Medicine-Jacksonville, Department of Internal Medicine and Department of Radiology in Jacksonville, Florida.
• Financial Disclosure: None reported.
• Support: None reported.
•  *Address correspondence to Julio C. Perez-Downes, DO, 4500 San Pablo Rd S, Jacksonville, FL 32224 Email: perez-downes.julio@mayo.edu

Article Information
Imaging / Neuromusculoskeletal Disorders / Pediatrics / Clinical Images
Clinical Images   |   July 2020
##### Straight Back Syndrome
The Journal of the American Osteopathic Association, July 2020, Vol. 120, 485.
The Journal of the American Osteopathic Association, July 2020, Vol. 120, 485.
A 33-year-old man with a history of hypertension presented to the hospital with a hypertensive emergency. Physical examination revealed a heart rate of 95 beats/min; blood pressure, 216/149 mm Hg; a 3/6 systolic murmur at the second intercostal space on the left, and a limited range of motion of the thoracic spine. Chest computed tomography revealed cardiomegaly, an anteroposterior thoracic diameter of 8.92 cm at the level of T8, and a lateral diameter of 29.8 cm at the level of the diaphragm. These findings were consistent with straight back syndrome (SBS; image A and image B).1
SBS is a congenital condition found incidentally during physical and radiographic evaluation. Diagnostic criteria include a ratio of the anteroposterior to the transverse diameter of less than or equal to 1:31 or a distance of 1.2 cm between the middle of the anterior border of T8 to a vertical line connecting T4 to T12 (image C).2 A pulmonic stenosis murmur was noted, presumed to be caused by compression of the right ventricular outflow tract by the SBS.3 Osteopathic manipulative treatment, such as high-velocity, low-amplitude techniques, may be used to improve somatic dysfunctions associated with this condition.3 No specific treatment is indicated.

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