Scoliosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical Examination

Skin

• Skin for café au lait spots indicative of neurofibromatosis
• Spina bifida as evidenced by a dimple, hairy patch, lipoma, or hemangioma.

Extremities

• Uneven hip and shoulder levels
• Unequal distance between arms and body
• The feet for cavovarus deformity

Neurologic

• Slow nerve action (in some cases)
• Abdominal reflexes
• Muscle tone for spasticity
• The patient's gait is assessed

Others

• Asymmetric size or location of breast in females
• Uneven musculature on one side of the spine
• A rib "hump" and/or a prominent shoulder blade, caused by rotation of the ribcage in thoracic scoliosis
• During the exam, the patient is asked to bend forward (Adam's Bend Test). If a hump is noted, then scoliosis is a possibility and the patient should be sent for an x-ray to confirm the diagnosis.