Poliomyelitis: NEET PG High-Yield
Neuromuscular & Orthopedic Sequelae
1. Pathophysiology
Poliovirus (Enterovirus) targets the anterior horn cells of the spinal cord, leading to flaccid paralysis. The hallmark is asymmetric involvement and loss of reflexes.
2. Orthopedic Sequelae
| Feature | Clinical Note |
|---|---|
| Limb Discrepancy | Due to impaired longitudinal growth of the affected limb. |
| Joint Deformities | Equinus foot is the most common deformity. Can lead to hip flexion contractures and scoliosis. |
| Gait | “Gluteus medius lurch” or “Trendelenburg gait” due to hip abductor weakness. |
3. NEET PG Examination Pearls
- Diagnostic Hallmark: Fever followed by acute flaccid paralysis (AFP). CSF shows lymphocytic pleocytosis.
- Orthopedic Management: Focused on corrective surgery (tendon transfers, osteotomies, arthrodesis) to stabilize joints once the patient reaches the “static” phase.
- Post-Polio Syndrome: New muscle weakness and pain occurring years after the initial infection.
- Vaccination: OPV (Sabin) vs. IPV (Salk). Remember that OPV is live attenuated and can rarely cause Vaccine-Associated Paralytic Polio (VAPP).