Because the changes in the spine are not accompanied by symptoms at the beginning, the diagnosis of “scoliosis” is often an incidental finding, for example, during a pediatric checkup or when taking an X-ray for another reason.
Scoliosis diagnostics: physical examination.
The following signs are typical changes that raise suspicion of scoliosis on physical examination, even if no pain or other scoliosis symptoms are present. While standing, the examination includes the following:
- Spinal column is bent to the left or right
- Shoulders are not straight – if you think of a line, it is not parallel to the floor
- The space between the waist and the arms hanging down (waist triangles) is asymmetrical in comparison
- Head is held obliquely
Bending the upper body forward, you can see that the back is not the same height on both sides of the spine:
- On one side there is an elevation due to the twisting of the vertebrae (“rib hump” or in the case of scoliosis on the lumbar spine “lumbar bulge”),
- While the other side appears particularly flat (“rib valley”) in comparison.
Diagnosis of scoliosis: further examinations
The most important tool for making a diagnosis of scoliosis is the X-ray of the spine. This is indispensable to determine scoliosis, its extent and location. For this purpose, the angle of curvature according to Cobb is measured – if it is more than 15 degrees, there is a need for scoliosis therapy.
Malalignment with a curvature of less than 10 degrees Cobb angle are quite common and only a few sufferers require treatment. Since many untreated scolioses often worsen, early detection and follow-up are of great importance.
During follow-up examinations, radiation exposure can be reduced by measuring the surface of the back (raster stereography) instead of x-raying the spine. This allows the physician to quickly determine whether the condition is stable. In addition, there are special examinations, for example, to check the function of the lungs and heart (bodyplethysmography, ECG) or to clarify whether there are impairments of other joints or organs due to the scoliosis (ultrasound).
