Screening
Name 2 out of 3 validated methods to screen for scoliosis in clinic.
-Forward bend test.
-Scoliometer
-Moire topography
Name that curve
Name the curve based on the direction of the apex
Cobb angle 10-19
Observe
True or false. Magnitude of curve correlates to back pain severity.
False
If screening is positive what is required for definitive diagnosis of scoliosis
XR PA spine to calculate Cobb angle
What is the Cobb angle
A.
Cobb angle of 20-29
What is the age is required for diagnosis of adolescent idiopathic scoliosis
Age greater than or equal to 10
USPSTF and AAFP recommendation for screening.
Recommend against routine screening. There is insufficient evidence that screening improve long term health outcomes compared to potential harms of screening.
What imaging should you should you repeat and at what frequency for a Cobb angle of 10-19
Every 6 months
Cobb angle of 30-39
Refer for bracing and physical therapy
The law and principle of spinal mechanics which explains the relation of Cobb angle and scoliometer measurement.
Fryette law Principle #1
Determines neutral segmental somatic dysfunction of the thoracolumbar spine due to facet orientation.
AAP recommendation for screening
Screen females at 10 AND 12 yo. Screen males at 13 or 14 yo.
What imaging should you should you repeat and at what frequency for a Cobb angle of 20-29
Cobb angle and Risser grade
Cobb angle > 40
Refer for surgical consultation
What BMI percentile is used to determine cut offs for positive scoliometer screening
BMI greater than or equal to the 85th percentile.
Scoliometer > 5
If BMI less than 85th percentile
Scoliometer > 7
If Cobb angle is 20-29 what should be the next screening test ordered?
Risser grading of the hips.
(Estimates skeletal maturity to determine risk of progression of curve). Grade 0-1 indicate less maturity and are higher risk of progression.
If there is a patient with confirmed scoliosis with pain that limits function what is the next study to complete?
MRI spine
Decrease progression in curve without change in quality of life.
What degree of scoliosis with duty limiting symptoms requires a med board
30 degrees