What are the methods for physical examination of scoliosis

If you feel that your spine has scoliosis in your life, you need to check it out as soon as possible, otherwise it may easily lead to deformity or displacement. The most common method for checking scoliosis is now using X-rays.

Physical examination

Pay attention to three important aspects: deformity, cause and complications.

First, fully expose yourself, wearing only shorts and loose outerwear that opens at the back. Pay attention to pigmentation lesions on the skin, the presence of café-au-lait spots and subcutaneous tissue tumors, and the presence of hair and cysts on the back. Pay attention to breast development, chest symmetry, presence of pectus excavatum, pectus carinatum, rib protrusions, and surgical scars. The examiner should observe carefully from the front, side and back.

The patient then faces the examiner and bends forward to observe whether the back is symmetrical: a bulge on one side indicates a rotational deformity of the costal canal and vertebral body. The examiner then observes the patient's waist from the back to see if it is symmetrical and to check if there is any rotational deformity of the lumbar spine. At the same time, pay attention to whether the two shoulders are symmetrical. It is also necessary to measure the distance between the costochondral angle and the hip bone on both sides. You can also put a plumb line from the C7 spinous process and then measure the distance from the buttocks crack to the vertical line to indicate the degree of deformity. Then check the range of motion of spinal flexion, extension, and lateral bending. Check the flexibility of each joint, such as the approximation of the wrist and thumb, hyperextension of the fingers, recurvature of the knee and elbow joints, etc.

Finally, a careful neurologic examination should be performed, particularly of the lower extremities. Patients suspected of having mucopolysaccharidosis should pay attention to the palate. People with Marfan syndrome should pay attention to their cornea.

The patient's height, weight, arm spacing, leg length, and sensation should all be recorded.

X-ray examination

1. An upright anteroposterior and lateral view of the entire spine. When taking X-rays, you must stand upright and not lie down. If the patient cannot stand upright, a sitting position should be used to reflect the true condition of scoliosis. It is the most basic means of diagnosis. The x-rays should include the entire spine.

2. Supine left and right flexion and traction images. Reflects its softness. If the Cobb angle is greater than 90 degrees or it is neuromuscular scoliosis, traction images are often used to check the elasticity of the scoliosis in order to estimate the degree of correction of the scoliosis and the length required for fusion of each column because there is no appropriate muscle to correct the scoliosis. The flexibility of kyphosis requires a hyperextended lateral view.

3. Oblique image. To check the spinal fusion, the oblique lumbar sacral view is used for patients with spondylolisthesis and spondylolysis.