Marfan syndrome is a variable autosomal dominant disorder; most cases result 
from mutations of fibrillin-1. Diagnosis is guided by the Ghent nosology. The 
condition may manifest in the cardiovascular and ocular systems. Musculoskeletal 
manifestations include scoliosis, dural ectasia, protrusio acetabuli, and 
ligamentous laxity. Compared with patients with idiopathic scoliosis, patients 
with Marfan syndrome tend to have scoliosis that progresses at a faster rate and 
is more resistant to bracing; undergo scoliosis surgery complicated by greater 
blood loss, pseudarthrosis, and additional curvature; and have more frequent 
occurrences of dural ectasia, which may cause headaches, leg pain, or perineal 
pain. Protrusio acetabuli may result in hip joint arthritis and may require 
valgus osteotomy or total hip arthroplasty.