Scoliosis Screening for Kids and Teens
Dr. Afshin Aminian, Medical Director of the CHOC Orthopaedic Institute, demonstrates scoliosis screening, which shows how to detect scoliosis in children and adolescents and when to refer to a specialist.
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Hello, I’m Dr. Afshin Aminian and today I’m going to demonstrate a scoliosis screening exam.
Scoliosis is an extremely prevalent condition. The screening exam is an important tool for early diagnosis and to hopefully prevent the progression of spinal deformity in children. Proper administration of the exam is vital to detection.
The first step of the scoliosis exam is inspection. For this, you will sit or stand right behind the child you are examining.
It’s important that children with longer hair place it in a ponytail or to the side as the first thing you will be inspecting is the shoulder height asymmetry. Shoulder height asymmetry is easily detected by feeling the top of the scapula, or shoulder blade, and noticing if one finger is higher than the other. The next thing you’ll do is to feel the top of the iliac crest. This will allow you to assess for length discrepancy. It is important that the child’s pants or dress is lower than the top of their iliac crest, their pelvis region, to assess this discrepancy.
The next step is the Adams Forward Bend Test. For this step, you will have the child relax and lean forward with the goal of evaluating the thoracic spine and the lumbar spine. You want to place the thoracic spine parallel to the floor. Since the spine is twisting and attached to the ribs, this is how you will detect any asymmetry during your exam.
The tool that we use for this portion of the exam is called the scoliometer. You will center the scoliometer on the middle of the spine, which is easily appreciated by palpitating the spinous processes, or bony prominences. Starting at the top of the neck, you will walk the scoliometer down the thoracic spine. When you want to get to the lumbar spine, have the child lean further down so the lumbar spine is parallel to the floor. This will allow you to detect any lumbar asymmetry more easily.
On your scoliometer, if the angle of trunk rotation, or ATR, is greater than 5 degrees that could potentially indicate significant spinal curvature that would necessitate referral to a specialist.
Here at CHOC, we have one of the most comprehensive spinal programs in the region and we are more than happy to answer any questions you may have about your child’s spinal health. We are here to give your child the best chance of growing into a healthy and happy adult free of spinal deformities.
