Idiopathic scoliosis in children or adolescents is usually first detected during a simple physical examination at a doctor’s visit. Some schools have programs in place for screening for scoliosis, just like some schools do vision and hearing screening tests in children. When an individual with scoliosis is standing upright, they may have shoulders or hips that appear uneven. In addition, one shoulder blade may appear to stick out more than the other one in people with scoliosis. In some cases, the spine is clearly visibly crooked as well, but this is not always the case. Some cases of scoliosis are mild and it is unlikely that a person would be able to notice these asymmetries unless they were looking for them.
If a doctor notices asymmetry in the shoulders, waist or pelvis, the doctor may have the patient bend forward to examine their back. The forward bend test makes the abnormal spinal curvature of scoliosis more easily visible and the doctor can determine where along the spine the curvature is located. During this test, a doctor may use a handheld device called a scoliometer to measure the severity of the curve in degrees. This device provides a quick estimate of the severity of the spinal curve without exposing a patient to X-rays. However, this device may underestimate the actual spinal curvature slightly compared to a measurement obtained from an X-ray.
The degree of the spinal curvature is measured most accurately by taking an X-ray image of the spine from front to back then measuring the angle that the spine deviates laterally. Curves that measure under 10 degrees are not considered scoliosis. Curves greater than 10 degrees are considered scoliosis, but they do not always cause problems or progress further. X-rays from the side may also be taken. An X-ray is all that is needed to diagnose scoliosis; it is the severity of the scoliosis that dictates whether a patient needs treatment or not. Treatment for scoliosis and when treatment is warranted will be discussed further in an upcoming article.
A patient who has a large abnormal spinal curvature may receive a neurological examination to make sure that their spinal nerves are functioning properly. If the doctor suspects that a patient’s scoliosis is not idiopathic— that is, if it has a suspected medical cause— they may also run further diagnostic tests. Examples of additional tests include medical imaging techniques such as MRIs, bone scans and CT scans.
References:
- http://www.mayoclinic.com/health/scoliosis/DS00194/DSECTION=tests%2Dand%2Ddiagnosis
- http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002221/
- http://www2.massgeneral.org/ortho/Scoliosis.htm
- http://www.theuniversityhospital.com/scoliosis/html/aboutscoliosis/whatis.htm
- http://www.scoliosis.org/store/scoliometer.php
