Look for spinal curve, kyphosis, tilted pelvis, or thoracic asymmetry on forward bending (estimated prevalence 2%-3%)

Negative

Positive

Check annually

End

Routine annual follow-up

Refer, regardless of age

X-ray q6mo

Follow q6mo
X-ray q12mo

Routine annual follow-up

X-ray q4mo

X-ray q6-12mo

Refer

Prepubertal

Pubertal

Post pubertal

^* Cobb method of angle measurement.

Find the lowest vertebra whose bottom tilts toward concavity of curve.
Erect a perpendicular line from extension of bottom surface.
Find highest vertebra as in #1 and erect perpendicular from extension of top surface.
Measure intersecting angle = angle of scoliosis.

Obtain standing AP film of spine^*

Curvature 5°

Curvature 5-10°

Curvature 10-20°

Curvature 20° or >

Prepubertal

Pubertal

Post-pubertal