Screening
What is scoliosis?Scoliosis is a sideways curvature of the spine greater than 10 degrees, which is measured by the Cobb angle. Curvature less than 10 degrees is considered normal variation.
When should my child be screened for scoliosis?
The Adams forward bend test is typically added to well visits starting at age 9-10 for girls, and 11-12 for boys, when large growth spurts can begin. If there is a family history of scoliosis, screening should begin earlier.
How do you screen for scoliosis?
During scoliosis screening, look for shoulder blade asymmetry, waistline asymmetry and trunk shift while standing. On the Adams forward bend test (bent forward at the waist, arms hanging and fingers together), look for the presence of any rib prominence or rotation of the spine. A scoliometer can also be used to help detect rotation, with a reading of 7 degrees or more indicating that imaging should be done.
Can scoliosis screening be done at home?
Yes, you can find instructions for performing the Adams forward bend test on Youtube, scoliometers can be purchased online, and there are free scoliometer apps. Any positive findings at home should be verified by your child's health care provider, as they will need to provide a referral for imaging.
How accurate are scoliometer readings?
Scoliometer readings measure scoliosis rotation, also known as vertebral rotation, or angle of trunk rotation (ATR), and do not always correspond to Cobb angle. It is possible to have mild scoliosis with a large degree of rotation, or severe scoliosis with a small degree of rotation. Imaging is required to confirm a diagnosis of scoliosis.
Why is no-dose or low-dose imaging important for children with scoliosis?
For children and teens who require frequent imaging to monitor progress of scoliosis, multiple doses of radiation from standard X-rays results in an increase in their life-long radiation exposure. Increased radiation for scoliosis patients has been shown to increase the risk of developing cancer later in life, especially endometrial and breast cancer. Radiation-free or low-radiation imaging is therefore recommended for frequent monitoring of scoliosis in children and adolescents.
What if my child is not a patient at a no-dose or low-dose imaging facility?
You do not typically have to be a patient at the facility to have imaging done there. Contact the facility directly and they will provide you with a referral form for your pediatrician. For a list of no-dose and low-dose radiation facilities that provide upright scoliosis imaging, click here.
How long does no-dose or low-dose scoliosis imaging take? Are you standing up during imaging?
Imaging is done standing up (weight-bearing) and usually takes less than 5 minutes.