{"id":16025,"date":"2023-04-25T11:49:30","date_gmt":"2023-04-25T03:49:30","guid":{"rendered":"https:\/\/scoliosis.hku.hk\/adolescent-idiopathic-scoliosis\/examination-and-diagnosis\/"},"modified":"2024-10-04T13:59:37","modified_gmt":"2024-10-04T05:59:37","slug":"examination-and-diagnosis","status":"publish","type":"page","link":"https:\/\/scoliosis.hku.hk\/en\/adolescent-idiopathic-scoliosis\/examination-and-diagnosis\/","title":{"rendered":"Examination and Diagnosis"},"content":{"rendered":"\n

\n History taking<\/strong>\n <\/strong>\n <\/h2>\n\n\n\n

The specialist will perform detailed medical history taking, including questions about birth, family history of scoliosis, growth events, activity level, other medical problems and any back pain.<\/p>\n\n\n\n

<\/div>\n\n\n\n

\n Physical examination<\/strong>\n <\/strong>\n <\/h2>\n\n\n\n
\n
\n

The child is asked to stand for assessing if any uneven shoulder or shift of the trunk. Then the child is asked to bend forward from the waist with arms relaxed on the side. The doctor will then see from behind at the spine and ribs to assess for any difference in height. One side of the ribcage can be more prominent or a back \u2018hump\u2019 can be seen. From the side, patients may have a normal appearance or a hypokyphosis of the thoracic spine. The specialist may also perform a neurological examination to assess for any muscle weakness, numbness and reflexes which are abnormal.<\/p>\n<\/div>\n\n\n\n

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\"\"<\/figure>\n<\/div>\n<\/div>\n\n\n\n
<\/div>\n\n\n\n

Radiographic examination<\/strong><\/strong><\/strong><\/h2>\n\n\n\n

On the spine radiograph, there is a lateral curvature of the spine with a Cobb angle greater than 10 degrees and vertebral rotation. This confirms the diagnosis of scoliosis.<\/em> Hypokyphosis can also be present. Some clinics have an imaging system with lower dose of radiation available for children\/adolescents, and it allows the x-rays from front and side views to be taken simultaneously.<\/p>\n\n\n\n

\n
\n
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Measurement of the Cobb angle<\/figcaption><\/figure>\n<\/div>\n\n\n\n
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Assessment of the bone age<\/figcaption><\/figure>\n<\/div>\n<\/div>\n\n\n\n

Skeletal maturity can be assessed on the spine and hand x-rays. The commonly used indices include Risser staging, distal radius and ulna (DRU) classification and Sanders staging. Risser staging examines the stages of ossification of the iliac crest apophyses.<\/p>\n\n\n\n

Both Sanders Staging and DRU classification can determine the bone age of a child using a hand radiograph. DRU is established locally by the Department of Orthopaedics and Traumatology, the University of Hong Kong. The degree of closure of the physis of the distal radius and ulna determines the DRU score and how much growth potential remains. This can help the specialist in deciding when to begin and stop b<\/a>racing, or to see when surgery is indicated.<\/p>\n\n\n\n

Magnetic resonance imaging (MRI) is not routinely recommended but it should be done if there is a suspicion of an underlying condition which causes the scoliotic curve. It is indicated if there is neurological abnormality on physical examination, significant back pain, or an atypical curve pattern. The specialist will advise based on the results of neurological and radiological examinations. Also, an MRI is needed for planning surgical procedures.<\/p>\n\n\n\n

Computed tomography (CT) scan is not needed routinely unless it is advised by the specialist, especially for patients who are contraindicated for MRI. CT allows detailed visualization of the size and shape of the spinal canal, and the intervertebral foramina.<\/p>\n","protected":false},"excerpt":{"rendered":"

History taking The specialist will perform detailed medical history taking, including questions about birth, family history of scoliosis, growth events, activity level, other medical problems and any back pain. Physical examination The child is asked to stand for assessing if any uneven shoulder or shift of the trunk. Then the child is asked to bend…<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":15932,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-16025","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/pages\/16025","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/comments?post=16025"}],"version-history":[{"count":7,"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/pages\/16025\/revisions"}],"predecessor-version":[{"id":16255,"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/pages\/16025\/revisions\/16255"}],"up":[{"embeddable":true,"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/pages\/15932"}],"wp:attachment":[{"href":"https:\/\/scoliosis.hku.hk\/en\/wp-json\/wp\/v2\/media?parent=16025"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}