Scoliosis

Scoliosis is a disease which involves a lateral curvature of the spine; that is, the spine is bent sideways.

Investigation

Those suspected of having scoliosis should undergo a thorough physical examination.

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During a physical examination, the following should be assessed:

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• Skin for café au lait spots indicative of neurofibromatosis
• The feet for cavovarus deformity
• The height of the iliac crests while standing
• Magnitude of the curve and rib hump both while standing and while leaning forward
• Asymmetrical shoulder levels
• Asymmetrical superficial abdominal reflexes
• Inequality of lengths of the upper limbs from the floor when leaning forward

During the exam, the patient's gait should be assessed, and there should be a search for signs of spinal abnormalities (e.g., dysraphism as evidenced by a dimple, hairy patch, lipoma, or hemangioma).

Related Topics:
Gait should be assessed - Sign - Dysraphism - Dimple - Lipoma - Hemangioma

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There should also be a thorough neurological examination.

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Ultimately, however, the main goal should be the assessment of curve severity and flexibility.

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Radiograghic investigation such as X ray or computed tomography (CT) should also be carried out to assess the location, levels of involvement, direction and magnitude of the curves.

Related Topics:
X ray - Computed tomography

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One method for assessing the curvature is the calculation of the Cobb angle, which assesses the curve from the top endplate of the topmost involved vertebra to the bottom endplate of the bottommost involved vertebra.

Related Topics:
Cobb angle - Vertebra

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A note here is that most patients will be unaware that they are afflicted with scoliosis even when curves exceed 30°.

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