Medical Health Encyclopedia

Other Physical Tests.

• The patient is usually requested to walk on the toes, then the heels, and then is asked to jump up and down on one foot. Such activities indicate leg strength and balance.
• The physician will also check leg length and look for tight tendons in the back of the leg, which may cause an uneven leg length or other back problems.
• The physician will also check for neurologic impairment by testing reflexes, nerve sensation, and muscle function.

Identifying the Curvature

Proper diagnosis is important. A misjudgment can lead to unnecessary x-rays and stressful treatments in children not actually at risk for progression. Unfortunately, although measurements of curves and rotation are useful, no test exists yet to determine whether a curve will progress.

Inclinometer (Scoliometer). An inclinometer, also known as a Scoliometer, measures distortions of the torso. The procedure is as follows:

• The patient bends over, arms dangling and palms pressed together, until a curve can be observed in the upper back (thoracic area).
• The Scoliometer is placed on the back and measures the apex (the highest point) of the upper back curve.
• The patient continues bending until the curve can be seen in the lower back (lumbar area). The apex of this curve is also measured.
• Measurements are repeated twice, with the patient returning to a standing position between repetitions.
• If results show a deformity, x-rays probably need to be performed to determine the extent.

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Some experts believe the Scoliometer would make a useful device for widespread screening. Scoliometers, however, indicate rib cage distortions in more than half of children who turn out to have very minor or no sideways curves. They are therefore not accurate enough to guide treatment.

Imaging Tests

Currently, x-rays are the most cost efficient method for diagnosing scoliosis. Experts hope that accurate, noninvasive diagnostic techniques will eventually be developed to replace some of the x-rays used to monitor the progression of scoliosis. To date, some under investigation appear to be fairly accurate for detecting scoliosis in the upper back (the thoracic region), but not scoliosis in the lower back (the lumbar region).