Scoliosis diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
MRI (magnetic resonance imaging) is the gold standard test for the diagnosis of scoliosis. In addition, x-rays and CT scan of the spine must be performed to monitor curve progression and look for vertebral anomalies.
Diagnostic Study of Choice
Study of choice
- MRI(magnetic resonance imaging) is the gold standard test for the diagnosis of scoliosis.[1][2][3]
- In addition, x-rays of the spine must be performed when:[4]
- The patient presents with atypical curve, low back pain, stiffness, and abnormal posture.
- X-rays also help in monitoring the progression of the curve.
The comparison of various diagnostic studies for scoliosis
| Test | Sensitivity | Specificity |
|---|---|---|
| MRI | 94.4% | 95.5% |
| X-ray | 95% | 35% |
Thus MRI is the preferred investigation based on the sensitivity and specificity
Diagnostic results
The following finding(s) on performing MRI are confirmatory for scoliosis:
- Abnormality that may be causing the deformity such as hemivertebra, wedge vertebra, and bilamina.[4][5]
- Spinal cord abnormalities such as syringomyelia, tonsillar herniation, and meningomyelocoele.[1]
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
Scoliosis Diagnostic Criteria
Based on literature, scoliosis may be diagnosed at any time if one or more of the following rule in criteria are met:[6] [7][8]
- Scoliometer measurement of >5°
- Cobb angle measurement, of a major structural curve, of >10° (cut-off based on natural history studies and evaluation of curve progression rates)
- Absence of other possible cause for the spinal deformity.
References
- ↑ 1.0 1.1 Calloni SF, Huisman TA, Poretti A, Soares BP (2017). "Back pain and scoliosis in children: When to image, what to consider". Neuroradiol J. 30 (5): 393–404. doi:10.1177/1971400917697503. PMC 5602330. PMID 28786774.
- ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.
- ↑ Diab M, Landman Z, Lubicky J, Dormans J, Erickson M, Richards BS; et al. (2011). "Use and outcome of MRI in the surgical treatment of adolescent idiopathic scoliosis". Spine (Phila Pa 1976). 36 (8): 667–71. doi:10.1097/BRS.0b013e3181da218c. PMID 21178850.
- ↑ 4.0 4.1 Hong A, Jaswal N, Westover L, Parent EC, Moreau M, Hedden D; et al. (2017). "Surface Topography Classification Trees for Assessing Severity and Monitoring Progression in Adolescent Idiopathic Scoliosis". Spine (Phila Pa 1976). 42 (13): E781–E787. doi:10.1097/BRS.0000000000001971. PMID 27811503.
- ↑ Imagama S, Kawakami N (2005). "Spatial relationships between a deformed vertebra and an adjacent vertebra in congenial scoliosis-failure of formation". J Jpn Scoliosis Soc. 20: 20–25.
- ↑ Janicki JA, Alman B (2007). "Scoliosis: Review of diagnosis and treatment". Paediatr Child Health. 12 (9): 771–6. PMC 2532872. PMID 19030463.
- ↑ Kesling KL, Reinker KA (1997). "Scoliosis in twins. A meta-analysis of the literature and report of six cases". Spine (Phila Pa 1976). 22 (17): 2009–14, discussion 2015. PMID 9306532.
- ↑ Parent S, Newton PO, Wenger DR (2005). "Adolescent idiopathic scoliosis: etiology, anatomy, natural history, and bracing". Instr Course Lect. 54: 529–36. PMID 15948477.