What is evaluated in the physical exam of patients with idiopathic scoliosis?

Updated: Dec 02, 2020
  • Author: Charles T Mehlman, DO, MPH; Chief Editor: Jeffrey A Goldstein, MD  more...
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Physical examination should include a baseline assessment of posture and body contour. Shoulder unleveling and protruding scapulae are common. In the most common curve pattern (right thoracic), the right shoulder is consistently rotated forward, and the medial border of the right scapula protrudes posteriorly.

Assessment of lower-extremity (and often upper-extremity) reflexes should be performed. Abdominal reflex patterns should also be assessed. The presence or absence of hamstring tightness should be investigated, and screening should be performed for ataxia and/or poor balance or proprioception (ie, Romberg test).

One or two different methods of measuring leg length will prove valuable, in that a significant percentage of patients presenting with scoliosis have several centimeters of limb-length discrepancy.

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