Diagnosing Scoliosis
This test requires a patient to bend forward at the waist with knees straight and feet together, allowing an observer to look for spinal, rib cage, or shoulder asymmetries.
Adam's forward bend test
What is the most common cause of acute back pain in children?
Muscle overuse (strain or sprain)
The management plan for patients with a Cobb's angle of less than 10
Clinically non-significant curve. No intervention required.
This tool is used to assess the degree of truncal rotation when asymmetry is observed on the Adams forward bending test.
Scoliometer
These sports involving repetitive lumbar hyperextension and rotation—including gymnastics, diving, weightlifting, football, and wrestling—are classically associated with this stress fracture causing lower back pain
Spondylolysis
Name one factor that is associated with increased progression of scoliosis.
1) Menarche status
2) Risser Score
3) Current Pubertal Stage
The number of degrees on the scoliometer indicating the need for an X-ray.
7 degrees
Name 2 red flag symptoms related to back pain indicating the need for additional work up.
fever, new onset incontinence, nighttime pain, weight loss, gait instability, calf atrophy, dermatomal sensory loss, weakness, loss of reflexes
The gold standard intervention when the patient's Cobb's angle is a greater than 45 degree curvature
Surgical Spinal Fusion
The name of the angle measured on a spinal xray to assess for scoliosis, and what degree should be referred to Orthopedics in a prepubertal patient?
Cobb angle, 20 degrees
A 7-year-old child presents with a 3-4 week history of progressive back pain and difficulty walking. The child appears ill and is febrile, with localized tenderness over the spine. On examination, the patient refuses to walk. This presentation is most concerning for?
Vertebral Osteomyelitis
What is the role of physical therapy for patients with scoliosis?
Assist with back pain alleviation, but does NOT change progression of the condition