II. Indications
- Scoliosis Screening
III. Technique: Adam's Forward Bending Test
- Most accurate visual screening method
- Patient position
- Patient with shirt off and spine fully visible
- Forward bending with feet together and knees straight
- Allow arms to hang down freely (or palms opposed)
- Examiner position
- Observe patient from behind (preferred position)
- Some school screening programs observe the patient from the front (may be less accurate)
- Abnormal findings: Unilateral changes
IV. Technique: Scoliometer
- Scoliometer measures trunk rotation
- Patient positioned as in forward bending above
- Scoliometer position
- Place Scoliometer on midline, perpendicular to spine
- Position at Vertebral level of maximum rib prominence
- Interpretation
- Scoliometer inclination <5 degrees typically warrants no further evaluation
- Inclination of 5-9 degrees suggest Scoliosis and warrants Scoliosis XRay (or 6 month recheck at minimum)
- Scoliometer inclination >10 degrees suggests severe Scoliosis and requires work-up
-
Scoliosis XRay Indications
- BMI <85%: Scoliometer measurement 7 degrees or more of trunk rotation (~20 degree Cobb Angle)
- BMI >85%: Scoliometer measurement 5 degrees or more of trunk rotation (~10 degree Cobb Angle)
V. Technique: Moire Topography
- Imaging machine maps the thoracic back topography, identifying abnormal curvature
- Investigated in the 1970s as a tool for school screening, but rarely used in the U.S.
VI. References
- Greene (2001) Musculoskeletal Care, AAOS, p. 697
- Lonstein (July 1989) J Musculoskeletal Med 37-54
- Bunnell (2005) Clin Orthop Relat Res (434): 40-5 [PubMed]
- Kuznia (2020) Am Fam Physician 101(1):19-23 [PubMed]
- Skaggs (1996) Am Fam Physician 53(7):2327-34 [PubMed]