Scoliosis

Diagnosis

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A doctor or parent may notice scoliosis during a child's growth spurt, or scoliosis may be detected through a screening at school. If scoliosis is suspected, a doctor should conduct a physical exam and order X-rays to confirm the condition.

Physical Examination

Most doctors can detect even mild curves by a physical exam of the spine as well as the shoulders, hips, legs and the rib cage. The exam may include the "Adams Forward Bending Test," in which a doctor looks for abnormal contours of the child's trunk.

During an exam, doctors consider a patient's health history and look for symptoms that may include:

• Uneven shoulders
• One shoulder blade that appears more prominent than the other
• Uneven waist
• One hip higher than the other
• Leaning to one side
• Limb length discrepancy
• Back pain or difficulty breathing (only in rare cases of severe scoliosis)

X-rays

A doctor may order an initial X-ray to confirm the diagnosis and determine spinal curvature. Subsequent periodic X-rays can monitor the curve's measurement and assist with treatment decisions.

Doctors describe a child's scoliosis based on the shape and location of the curve plus other factors:

• Shape. Curves develop side-to-side as C- or S-shapes. The rotation of the spine causes the attached ribs and muscles near the spine to migrate into an abnormal position.
• Location. The curve may occur in the upper back (thoracic), the lower back (lumbar) or in both areas (thoracolumbar).
• Direction. The curve can bend to the left or right.
• Angle. Doctors measure the angle of the curve using the vertebra (spine bone) at the apex of the curve. A normal spine, viewed from the back, is at 0 degrees from vertical — or a straight vertical line. A curve that runs horizontal, or parallel to the floor when the patient is sitting or standing, is described as 90 degrees. Scoliosis is defined as a spinal curvature of greater than 10 degrees.