Scoliosis
A lateral curvature of the spine, usually 10 degrees or more. It may be classified as structural (fixed) or nonstructural (correctable). It is named for the convexity of the spinal curve.
Demographics
Age at onset: most curves are found in adolescents, but the onset is variable
Sex: female to male 7:1
Prevalence: 4 per 1000 persons
Clinical Presentation
• Scoliosis is typically not a source of pain in the adolescant
• The adolescant may be coming to PT for another issue, but should be screened because early detection is key in treatment
Differential Diagnosis
• Adam’s Test
• Observe shoulders and pelvis to determine if they are level
• Palpate the spinous processes to determine their alignment
• Imaging: radiographs are necessary to determine the amount of curvature if scoliosis is suspected; severity of the curve is measure din degrees using the Cobb method
Clinical Bottom Line: Treat and Refer
All children and adolescents presenting to physical therapy should be screened for scoliosis because early detection can prevent dibilitating deformity later in life. Radiographs are necessary to determine the amount of curvature of the spine, thus a referral to an orthopedic doctor is warranted if scoliosis is suspected.
References:
Please refer to the "Scoliosis" section of the reference list.
Demographics
Age at onset: most curves are found in adolescents, but the onset is variable
Sex: female to male 7:1
Prevalence: 4 per 1000 persons
Clinical Presentation
• Scoliosis is typically not a source of pain in the adolescant
• The adolescant may be coming to PT for another issue, but should be screened because early detection is key in treatment
Differential Diagnosis
• Adam’s Test
• Observe shoulders and pelvis to determine if they are level
• Palpate the spinous processes to determine their alignment
• Imaging: radiographs are necessary to determine the amount of curvature if scoliosis is suspected; severity of the curve is measure din degrees using the Cobb method
Clinical Bottom Line: Treat and Refer
All children and adolescents presenting to physical therapy should be screened for scoliosis because early detection can prevent dibilitating deformity later in life. Radiographs are necessary to determine the amount of curvature of the spine, thus a referral to an orthopedic doctor is warranted if scoliosis is suspected.
References:
Please refer to the "Scoliosis" section of the reference list.
Adam's Test is commonly used to screen for scoliosis. The patient is asked to bend forward with the feet together and knees straight while dangling the arms. Asymmetry of the rib cage may indicate thoracic scoliosis. This test is effective in identifying thoracic scoliosis but may miss scoliosis in the lumbar spine.