How Is Scoliosis Diagnosed? An Ultimate Guide

Scoliosis is a condition that affects the curvature of the spine. It can be caused by various factors, including congenital malformation, underlying health conditions, rapid growth, and injuries. Understanding the diagnosis will help you know what to expect during the process and ensure that you get the most accurate diagnosis possible.

This blog post will discuss the different methods doctors use to diagnose scoliosis. We will also talk about the importance of getting an early diagnosis and how it can help improve your treatment plan.

Use Of Cobb Method For Measuring Curve Severity

The Cobb method is the most common way to measure the severity of a spinal curve, although other methods may be more accurate. A line is drawn along the bottom of the vertebra of greatest angle of the curvature, and another across the top of the vertebra with the greatest angle. Another line is drawn perpendicular to each of these lines. The angle between these two lines is then measured.

A curve is significant if it measures greater than 20 degrees. Those measuring more are considered moderate to severe and need more aggressive treatment. This angle is called the Cobb angle, and it provides a reasonable estimate of the degree of curvature in patients with scoliosis.

About Adam’s Forward Bend Test

The Adam’s forward bend test is the most common test to detect scoliosis. It is performed by having the person with suspected scoliosis bend forward from the waist, with their arms hanging down. The doctor or other trained professional will then look for any curvature in the spine and any unevenness in the shoulders or hips.

The Adam’s forward bend test is considered less accurate in diagnosing scoliosis, which means that it can miss some cases. However, it is still the best for screening and during the initial diagnosis and is recommended for all children over 8 as part of their regular physical exams.

If scoliosis is suspected based on Adam’s forward bend test results, the next step is usually to get an X-ray of the spine. This will allow the doctor to confirm the diagnosis and determine the severity of the curve. In some cases, further testing may be needed to rule out other causes of back pain or unevenness, such as abnormal posture, a herniated disc, or pelvic issues.

Use Of Imaging Tests

Imaging tests are among the most accurate methods for understanding the severity. They include:

1. X-Ray: An x-ray is the most common way to diagnose scoliosis and is considered the standard of care. It can show the degree of the curve and if there is a risk of progression.

2. Computed Tomography Scan (CT Or CAT Scan): This test provides a more detailed image of the spine than an x-ray. It can look for other problems that might be causing scoliosis, such as a tumor.

3. Magnetic Resonance Imaging (MRI): This test is used less often than x-rays or CT scans. It can provide more information about the spinal cord, brain, brain stem, and nerves.

The doctor will also ask about your child’s medical history and do a physical exam. The exam will include looking at the spine and checking for unevenness in the shoulders or hips. The doctor may also ask your child to bend forward from the waist. This is done to see if there is any curving of the spine.

A diagnosis of scoliosis is usually made based on the results of the physical exam and imaging tests. The doctor may also order advanced imaging like MRI. These tests look for other conditions that can cause scoliosis, such as muscular dystrophy or cerebral palsy.

Once scoliosis is diagnosed, the doctor will classify it as mild, moderate, or severe based on the degrees of curvature. The doctor will also determine the risk of progression and if the curve is getting worse. This is done by measuring the Risser Sign at the pelvis to determine skeletal maturity, or comparison of the curve on x-rays taken at different times.

How Is Adult Scoliosis Diagnosed?

Adult scoliosis is diagnosed differently than childhood scoliosis, as the underlying causes and treatment goals are different after skeletal maturity. The adults can be classified as:

  • Adults with degenerative scoliosis
  • Adults who got scoliosis in childhood
  • Adults who don’t seek medical attention when younger

Degenerative scoliosis is a sideways curvature of the thoracic and lumbar spine that occurs as we age. The condition is also known as adult onset scoliosis or de novo scoliosis. Degenerative scoliosis most often affects people over the age of 65, and women are affected more often than men.

The cause of adult degenerative scoliosis is thought to be related to the arthritic process that leads to spinal deformity. The intervertebral discs, which act as cushions between the vertebrae, deteriorate with age and bone spurring/deformity can occur. This deterioration can lead to instability in the spine, resulting in a curvature of the spine. Surgical and non-surgical treatment are viable options to deal with it. Sometimes, an advanced case requires surgery.

Your doctor will order X-rays of your spine. These images can show the degree of the curve and whether it is getting worse. In some cases, MRI or CT scans may be needed to look at the spine. Remember, the goal of adult scoliosis treatment may be reduction, but stabilization of the curvatures may be the primary goal in adults.

What’s The Treatment?

If scoliosis is mild and not progressing, the doctor may suggest a nighttime or part time brace with regular exams and x-rays. If the curvature is more advanced, the doctor may recommend Scolibrace treatment or surgical consultation in advanced cases. Treatment options for scoliosis include:

1. Observation

For children who have a mild curvature that is not progressing, the doctor may monitor the condition with regular exams and x-rays. This is usually done every four to six months. In most cases, nighttime bracing is enough to decrease the curvature. Scoliosis specific exercise may be taught as part of this plan.

2. Surgery

Surgery is an option for children or adults who have a severe curvature. The goal of surgery is to stop the curve from getting worse and reduce the deformity. There are different types of scoliosis surgery, and the specific surgery would need to be suggested by your surgeon after a thorough examination.

After surgery, the child may need to wear a brace for several months. The brace will help to hold the spine in place while it heals. Physical therapy may also be recommended after surgery.

3. Scolibrace

A Scolibrace is often used to treat children who have a moderate to severe curvature and are still growing. The goal of bracing is to stop the curve from getting worse. It may help to reduce and stabilize an existing curve. There are different types of braces, including:

  • Scolibrace: This brace extends from under the arms to the hips, and typically is used in cases where the scoliosis affects the upper and lower back. There may be a primary and a secondary curvature. It can also be designed for low back-only curvatures.
  • Scolibrace also is designed to reduce and stabilize a hyperkyphosis. This curvature seen from the side can occur together with scoliosis, or sometimes on it’s own.
  • Other braces may be less effective and may not have been designed for curvature reduction or stabilization. The may be a one-size-fits-all design, whereas Scolibrace is designed for each individual’s unique curvature.
  • Scoliosis specific exercise may be taught as part of this plan.

FAQs

1. What Is Scoliosis?

As per the scoliosis research society, it is a condition that affects the spine. It is characterized by a side-to-side spinal curvature. Scoliosis can occur in children or adults, but it is most common during adolescence. Treatment options for scoliosis include observation, bracing, and surgery.

2. How Can Scoliosis Be Classified?

The main types of scoliosis include congenital and neuromuscular. Another type is most commonly called idiopathic scoliosis. Congenital scoliosis is present at birth, while neuromuscular scoliosis is caused by an underlying medical condition, such as cerebral palsy or muscular dystrophy. Adolescent Idiopathic scoliosis is the most common type and is diagnosed at the time of puberty as the rapid growth phase begins.

3. What Are Symptoms Of Scoliosis?

The most common symptom of Scoliosis is a curvature of the spine causing change in posture. Other Scoliosis symptoms may include uneven shoulders, one hip higher than the other, or a visible rib hump. Scoliosis can also cause back, neck, and leg pain.

4. Are There Any Lifestyle And Home Remedies For Dealing With It?

No, there is no home remedy known for dealing with scoliosis. However, some treatments can help manage the condition and prevent it from getting worse. These include wearing a Scolibrace, scoliosis specific exercises, or may require surgery in advanced cases.

5. When Should I See A Doctor?

You should see a doctor if you notice any signs or symptoms of scoliosis, or think it is progressively getting worse. This is especially important if you have a family history of the condition. Early diagnosis and treatment is important for best results. Children should be checked as early as 8 years of age.

6. How Is It Diagnosed In Children?

Most scoliosis cases are diagnosed in children between the ages of 10 and 15. Doctors can detect scoliosis during a routine physical exam by looking for sure signs in almost all cases.

The most common sign of scoliosis is when one shoulder appears higher than the other. Another sign is when the ribs on one side of the body stick out further than on the other side, or one shoulder blade sticks out further than the other. Sometimes, children with scoliosis may lean to one side.

In some cases, scoliosis may be difficult to detect during a physical exam. In these cases, an X-ray may be needed to confirm the diagnosis.

Summing Up

While scoliosis can be detected through a physical examination, imaging tests are often used to diagnose it more accurately. If you’re experiencing back pain, it’s essential to see a doctor and get screened for scoliosis. Early detection is critical in preventing the curve from worsening.