Scoliosis is a disorder indicated by an abnormal curve of the spine. It is twice as common in girls than boys. There are three main type of scoliosis. Functional scoliosis develops from a problem in another part of the body, such as when one leg is longer than the other. Neuromuscular scoliosis occurs when there is a problem during the formation of the bones. Degenerative scoliosis occurs in older adults and is caused by degenerative conditions such as arthritis.
Physical Examination
The most frequently used screening method is called the Adams Forward Bend Test. In this test, the child bends forward at the waist with knees together and feet straight while the physician examines the spine from behind the child. If there is any abnormality in the symmetry of the shoulder blades or rib cage, it could be an indication of scoliosis. This test may miss approximately 15 percent of scoliosis cases, so additional tests for symmetry are also used during physical examination.
During other tests, the patient walks on toes and heels and jumps on one foot to evaluate leg strength and balance. The doctor will measure the length of the legs and check for tight tendons in the legs, which can cause back problems.
If a curvature is noticed during physical examination, X-rays are then ordered to determine the amount of the curvature and consider treatment options. A curvature of less than 10 percent is not often treated and rarely progresses to a more serious stage. However, the progression of all noticeable curvatures should be monitored. Curves of 20 to 30 percent should be screened every three months.
X-Ray
When scoliosis has been diagnosed during a physical examination, X-rays are taken to evaluate the extent of the condition and to establish a baseline for comparison of future X-rays to monitor progression. X-rays are taken every three to six months, and treatment options are considered based on the extent of the curvature.
Magnetic Resonance Imaging
Although not used for initial diagnosis, when scoliosis has been diagnosed an MRI may be ordered to provide a more comprehensive assessment of the condition. During an MRI, other conditions may be noticed that can contribute to the cause of scoliosis so an effective treatment plan can be developed based on other structural abnormalities. In addition, an MRI may detect other defects that could lead to potential complications if surgery is required.
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