Diagnosis
The severity of scoliosis and need for treatment is usually determined by two factors:
- The extent of the spinal curvature. (Scoliosis is diagnosed when the curve measures 11 degrees or more.)
- The angle of the trunk rotation (ATR).
Both are measured in degrees. These two factors are usually related. For example, a person with a spinal curve of 20 degrees will usually have a trunk rotation (ATR) of 5 degrees. These two measurements, in fact, used to be the cutoff for recommending treatment. However, it is now well known that the great majority of 20-degree curves do not get worse. Patients do not usually need medical attention until the curve reaches 30 degrees and the ATR is seven degrees.
Physical Examination
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Adam's Forward Bend Test. The screening test used most often in schools and in the offices of pediatricians and primary care physicians is called the Adam's forward bend test.
The child bends forward dangling the arms, with the feet together and knees straight. The curve of structural scoliosis is more apparent when bending over. In a child with scoliosis, the examiner may observe an imbalanced rib cage, with one side being higher than the other, or other deformities.
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| The forward bend test is a test used most often in schools and doctor's offices to screen for scoliosis. During the test, the child bends forward with the feet together and knees straight while dangling the arms. Any imbalances in the rib cage or other deformities along the back could be a sign of scoliosis. |
The forward bend test, however, is not sensitive to abnormalities in the lower back, a very common site for scoliosis. Because the test misses about 15% of scoliosis cases, many experts do not recommend it as the sole method for screening for scoliosis.
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