Signs of Scoliosis

Scoliosis is the medical condition where the spine is curved or crooked from side to side.  Viewed on an x-ray and from the rear, the spine of a person with scoliosis may look like the letter “C” or in some cases the letter “S”.  Scoliosis can be classified as either congenital (a defect or abnormality already present at birth), idiopathic (a defect with unknown cause – this is further sub-classified according to the stage of the person’s life when it was diagnosed. The sub-classifications are: infantile, juvenile, adolescent and adult.), or neuromuscular (a defect that developed as an offshoot of another symptom such as physical trauma, spinal muscular atrophy, spina bifida, or cerebral palsy).  In the United States alone, it is estimated that more than 7 million people suffer from scoliosis.

Patients with scoliosis that have reached the full maturity of their skeletal systems are very unlikely to have worsening conditions.  Severe cases of this condition however can lead to highly diminished capacity of the lungs, severe physical pressure on the heart, and a lot of restrictions on a lot of common physical activities.  Scoliosis is sometimes related to other medical conditions such as hyper-flexibility, connective tissue disorders, neurofibromatosis, amniotic band syndrome, and mitral valve prolapse.

The most common signs of scoliosis are:  uneven muscular growth along either side of the spine; prominence of the shoulder blades or the ribs; uneven lengths of the legs or uneven hips; and in some cases, very slow nerve action.

Patients who are initially diagnosed with scoliosis are checked up more thoroughly to determine if the cause of the deformity could be found.  During this physical examination, the patient’s skin is tested for any indication of neurofibromatosis, the feet are tested for cavovarus deformities, the abdominal muscles are tested for reflex action, and overall muscle tone is tested for plasticity.  Also during the physical examination, the patient is asked to perform the Adams Forward Bend Test.  This is a simple task of bending forward with the shirt removed so as to show the spine.  If a prominence is observed, scoliosis is deemed a possibility and an x-ray is ordered for confirmation. An alternative to the Adams Forward Bend Test is the use of a scoliometer. 

When scoliosis is determined to be the possible condition of a patient, it is a usual practice to arrange two types of x-rays to be taken.  The first one is a full spine, coronal (front view and back view), weight bearing x-ray, and the second one is a lateral or side-view x-ray.  These 2 x-rays are needed to assess the spinal curves brought about by the scoliosis from side to side and the curves that might cause a “hunchback” condition or a “saddleback” condition.

Full length x-rays of the spine are used to determine the classification of the scoliosis.  These are also used to determine the severity of the condition and its progression.  In patients that are still in the growth stage, serial x-rays are taken at intervals of 3-12 months to allow the doctors to follow the progression of the curve.

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