Patient history: Includes menstrual history, birth and developmental history, and inquiry regarding family history of scoliosis PHYSICAL EXAMINATION
• Height and weight assessment
• Observation (look for shoulder, thorax, or waist asymmetry)
• Adams forward bend test. The right and left sides of the trunk should be symmetrical. Presence of a thoracic or lumbar prominence suggests scoliosis. Use a scoliometer to quantitate asymmetry
• Neurologic assessment. Includes motor strength testing, deep tendon reflexes, abdominal reflexes (abnormalities may indicate intraspinal pathology such as syringomyelia), plantar reflexes, clonus testing
• Upper and lower extremity assessment. Include gait and leg length evaluation
• A standing posteroanterior (PA) long cassette radiograph is the initial view obtained
• Lateral radiographs are indicated when sagittal plane abnormalities are noted on physical examinations, for patients with back pain, when spondylolisthesis is suspected, and for presurgical planning prior to scoliosis correction
• Side-bending radiographs are indicated for defining curve type for presurgical planning prior to scoliosis surgery but are not required for a routine initial patient evaluation
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