There are several different "warning signs" to look for to help determine if you or someone you love has scoliosis. Should you notice any one or more of these signs, you should schedule an exam with a doctor.
- Shoulders are different heights – one shoulder blade is more prominent than the other
- Head is not centered directly above the pelvis
- Appearance of a raised, prominent hip
- Rib cages are at different heights
- Uneven waist
- Changes in look or texture of skin overlying the spine (dimples, hairy patches, color changes)
- Leaning of entire body to one side
A standard exam that is often used by pediatricians and in initial school screenings is called the Adam's Forward Bend Test. Most schools test children in the fifth or sixth grade, and the Adam's Forward Bend Test can be administered easily by school nurses or parent volunteers. For this test, the patient is asked to lean forward with his or her feet together and bend 90 degrees at the waist. The examiner can then easily view from this angle any asymmetry of the trunk or any abnormal spinal curvatures. It should be noted that this is a simple screening test that can detect potential problems, but cannot determine accurately the exact severity of the deformity.
Once suspected, scoliosis is usually confirmed with an x-ray, spinal radiograph, CT scan, MRI or bone scan of the spine. The curve is then measured by the Cobb Method and is discussed in terms of degrees. Generally speaking, a curve is considered significant if it is greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment.
The following is a list of questions your physician/orthopaedic specialist may ask:
- At what age was the spinal deformity first noted? This information is important in determining the prognosis and severity of the scoliosis.
- Who first noted the problem? Parent? Teacher? Physician?
- What is the patient's prenatal history? Did the child experience any problems while still in his or her mother's womb? Was there anything unusual about the pregnancy?
- Did the patient meet normal developmental milestones? Walking? Talking?
- Is there a family history of scoliosis or other spinal problems? You are 20 percent more likely to develop scoliosis if someone in your family also has scoliosis.
- Is the patient experiencing any back pain? Generally speaking, scoliosis in children and adolescents is not painful. If pain exists, further tests should be conducted for tumors, herniated discs or other abnormalities.
The doctor may also conduct exams to test reflexes, motor and sensory functions, and breathing ability. After a diagnosis is made, your doctor will suggest a treatment plan.
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