Orthopedics Book

Thoracic Spine Disorders

  • Scoliosis Examination


Scoliosis Examination

Aka: Scoliosis Examination, Forward Bending Test, Scoliometer, Adam's Test, Adam's Position, Adam's Forward Bend Test
  1. See Also
    1. Scoliosis
    2. Scoliosis XRay (Cobb Angle)
  2. Indications
    1. Scoliosis Screening
  3. Technique: Adam's Forward Bending Test
    1. Most accurate visual screening method
    2. Patient position
      1. Patient with shirt off and spine fully visible
      2. Forward bending with feet together and knees straight
      3. Allow arms to hang down freely (or palms opposed)
    3. Examiner position
      1. Observe patient from behind (preferred position)
      2. Note that in some school screening programs the patient is observed from the front of the patient (may be less accurate)
    4. Abnormal findings: Unilateral changes
      1. Rib Cage elevation on one side (rib hump)
      2. Prominent unilateral lumbar paravertebral muscle
  4. Technique: Scoliometer
    1. Scoliometer measures trunk rotation
    2. Patient positioned as in forward bending above
    3. Scoliometer position
      1. Place Scoliometer on midline, perpendicular to spine
      2. Position at Vertebral level of maximum rib prominence
    4. Interpretation
      1. Scoliometer inclination <5 degrees typically warrants no further evaluation
      2. Inclination of 5-9 degrees suggest Scoliosis and warrants Scoliosis XRay (or 6 month recheck at minimum)
      3. Scoliometer inclination >10 degrees suggests severe Scoliosis and requires work-up
      4. Seven degrees by Scoliometer correlates with 20 degree Cobb Angle on Scoliosis XRay
  5. References
    1. Greene (2001) Musculoskeletal Care, AAOS, p. 697
    2. Lonstein (July 1989) J Musculoskeletal Med 37-54
    3. Bunnell (2005) Clin Orthop Relat Res (434): 40-5 [PubMed]
    4. Skaggs (1996) Am Fam Physician 53(7):2327-34 [PubMed]

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