Adolescent idiopathic scoliosis: diagnosis and management.
Scoliosis is an abnormal lateral curvature of the spine greater than 10 degrees with vertebral rotation. The most common type is adolescent idiopathic scoliosis with males and females equally affected but females 5-10 times more likely to progress to severe disease.
Scoliosis screening can be done during routine school physical exams. The main test used for scoliosis evaluation is the Adams forward bend test, which consists of the patient standing and bending forward at the waist, and the examiner assesses for symmetry of the back from behind and beside the patient. Patients with scoliosis will have a rib hump which is visible on exam. The examiner can then use a scoliometer to determine the amount of spinal curve and rotation. For official diagnosis of scoliosis a Cobb angle measurement using radiography is needed.
The 3 major factors that determine whether scoliosis will progress are female sex, greater magnitude of curve on presentation and growth potential ie younger age. Treatment options include observation, bracing and surgery. > From: Horne et al., Am Fam Physician 89 (2014) 193-198. Copyright American Academy of Family Physicians.
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