Last reviewed: November 2017
Last updated: October  2016

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • age >10 years
  • 6 to 12 months post puberty
  • postural asymmetry
  • absent or minimal pain
  • absence of neurological symptoms with normal neurological exam
  • paraspinal prominences on forward bending
  • scoliometer measurement of >5° at paraspinal prominence
  • symmetric abdominal reflexes

Other diagnostic factors

  • shoulder asymmetry
  • waist-line asymmetry
  • thoracic wall or breast asymmetry
  • normal gag reflex
  • truncal decompensation

Risk factors

  • positive FHx
  • peak adolescent growth spurt

Diagnostic investigations

Investigations to consider

  • standing PA x-rays of cervical, thoracic, and lumbar spine, and pelvis
  • standing lateral x-rays of cervical, thoracic, and lumbar spine, and pelvis
  • MRI of cervical, thoracic, lumbar, and sacral spine, and brainstem
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Pediatric Orthopaedic Surgeon

Department of Orthopaedics

Nemours Children’s Hospital

Orlando

FL

Disclosures

RMI declares that he has no competing interests.

Ignacio V. Ponseti Chair and Professor of Orthopaedics

Department of Orthopaedics and Rehabilitation

University of Iowa Hospitals and Clinics

Iowa City

IA

Disclosures

SLW is a former board member of the Journal of Bone and Joint Surgery (ended in 2013); he was involved in a NIH RO1 research grant programme until 2015; and he is an author of several references cited in this monograph.

Peer reviewers VIEW ALL

Associate Chief of Orthopaedic Surgery

The Children's Hospital of Philadelphia

Philadelphia

PA

Disclosures

JMF declares that he has no competing interests.

Director

Pediatric Spine Surgery

Shriners Hospitals for Children

Philadelphia

PA

Disclosures

AS is a paid consultant for Synthes Spine, Depuy Spine, and SpineVision.

Neurosurgeon

Department of Neurosurgery

Hospital Munich-Bogenhausen

Munich

Germany

Disclosures

AT declares that he has no competing interests.

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