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Pediatrics
Diagnosis
Spine
Congenital and Genetic Disorders
Scoliosis and Kyphosis
Scoliosis
Scoliosis
Blaise V. Jones, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Lateral curvature of spine > 10°
            • Dextroscoliosis: Curve convex to right
            • Levoscoliosis: Curve convex to left
            • Kyphoscoliosis: Scoliosis with component of kyphosis
            • Rotoscoliosis: Scoliosis that includes rotation of vertebrae
            • S-curve scoliosis: 2 adjacent curves, 1 to right & 1 to left
            • C-curve scoliosis: Single curve
            • Terminal vertebra: Most tilted superior & inferior vertebra of curve
            • Transitional vertebra: Vertebra between 2 curves
            • Apical vertebra: Vertebra with greatest lateral displacement from midline; also least tilted
            • Primary curvature: Curvature with greatest angulation
            • Secondary or compensatory curvature: Smaller curve, which balances primary curvature
            • Structural curve: Curvature that will not correct with ipsilateral bending

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Idiopathic Scoliosis

                              • Congenital Scoliosis

                                • Neuromuscular, Developmental, Tumor Associated

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Reporting Tips

                                              Selected References

                                              1. Halawi MJ et al: Neuromuscular scoliosis: Current Concepts. Orthopedics. 38(6):e452-6, 2015
                                              2. Harris JA et al: A comprehensive review of thoracic deformity parameters in scoliosis. Eur Spine J. 23(12):2594-602, 2014
                                              3. Waldt S et al: Measurements and classifications in spine imaging. Semin Musculoskelet Radiol. 18(3):219-27, 2014
                                              4. Hresko MT: Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med. 368(9):834-41, 2013
                                              5. Wybier M et al: Musculoskeletal imaging in progress: the EOS imaging system. Joint Bone Spine. 80(3):238-43, 2013
                                              6. Westrick ER et al: Adolescent idiopathic scoliosis: 5-year to 20-year evidence-based surgical results. J Pediatr Orthop. 31(1 Suppl):S61-8, 2011
                                              7. Kim H et al: Scoliosis imaging: what radiologists should know. Radiographics. 30(7):1823-42, 2010
                                              8. Weinstein SL et al: Adolescent idiopathic scoliosis. Lancet. 371(9623):1527-37, 2008
                                              9. Arlet V et al: Congenital scoliosis. Eur Spine J. 12(5):456-63, 2003
                                              10. Daffner SD et al: Adult degenerative lumbar scoliosis. Am J Orthop. 32(2):77-82; discussion 82, 2003
                                              11. Ahn UM et al: The etiology of adolescent idiopathic scoliosis. Am J Orthop. 31(7):387-95, 2002
                                              12. Berven S et al: Neuromuscular scoliosis: causes of deformity and principles for evaluation and management. Semin Neurol. 22(2):167-78, 2002
                                              13. Cassar-Pullicino VN et al: Imaging in scoliosis: what, why and how? Clin Radiol. 57(7):543-62, 2002
                                              14. Do T: Orthopedic management of the muscular dystrophies. Curr Opin Pediatr. 14(1):50-3, 2002
                                              15. Geijer H: Radiation dose and image quality in diagnostic radiology. Optimization of the dose-image quality relationship with clinical experience from scoliosis radiography, coronary intervention and a flat-panel digital detector. Acta Radiol Suppl. 43(427):1-43, 2002
                                              16. Jones KB et al: Spine deformity correction in Marfan syndrome. Spine. 27(18):2003-12, 2002
                                              17. Lenke LG et al: Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment? Spine. 27(6):604-11, 2002
                                              18. Redla S et al: Magnetic resonance imaging of scoliosis. Clin Radiol. 56(5):360-71, 2001
                                              19. Thomson JD et al: Scoliosis in cerebral palsy: an overview and recent results. J Pediatr Orthop B. 10(1):6-9, 2001
                                              20. Jaskwhich D et al: Congenital scoliosis. Curr Opin Pediatr. 12(1):61-6, 2000
                                              21. Lowe TG et al: Etiology of idiopathic scoliosis: current trends in research. J Bone Joint Surg Am. 82-A(8):1157-68, 2000
                                              22. Mohaideen A et al: Not all rods are Harrington - an overview of spinal instrumentation in scoliosis treatment. Pediatr Radiol. 30(2):110-8, 2000
                                              23. Roach JW: Adolescent idiopathic scoliosis. Orthop Clin North Am. 30(3):353-65, vii-viii, 1999
                                              24. Oestreich AE et al: Scoliosis circa 2000: radiologic imaging perspective. I. Diagnosis and pretreatment evaluation. Skeletal Radiol. 27(11):591-605, 1998
                                              25. Oestreich AE et al: Scoliosis circa 2000: radiologic imaging perspective. II. Treatment and follow-up. Skeletal Radiol. 27(12):651-6, 1998
                                              26. Kim HW et al: Spine update. The management of scoliosis in neurofibromatosis. Spine. 22(23):2770-6, 1997
                                              Related Anatomy
                                              Loading...
                                              Related Differential Diagnoses
                                              Loading...
                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Lateral curvature of spine > 10°
                                                        • Dextroscoliosis: Curve convex to right
                                                        • Levoscoliosis: Curve convex to left
                                                        • Kyphoscoliosis: Scoliosis with component of kyphosis
                                                        • Rotoscoliosis: Scoliosis that includes rotation of vertebrae
                                                        • S-curve scoliosis: 2 adjacent curves, 1 to right & 1 to left
                                                        • C-curve scoliosis: Single curve
                                                        • Terminal vertebra: Most tilted superior & inferior vertebra of curve
                                                        • Transitional vertebra: Vertebra between 2 curves
                                                        • Apical vertebra: Vertebra with greatest lateral displacement from midline; also least tilted
                                                        • Primary curvature: Curvature with greatest angulation
                                                        • Secondary or compensatory curvature: Smaller curve, which balances primary curvature
                                                        • Structural curve: Curvature that will not correct with ipsilateral bending

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Idiopathic Scoliosis

                                                                          • Congenital Scoliosis

                                                                            • Neuromuscular, Developmental, Tumor Associated

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Halawi MJ et al: Neuromuscular scoliosis: Current Concepts. Orthopedics. 38(6):e452-6, 2015
                                                                                          2. Harris JA et al: A comprehensive review of thoracic deformity parameters in scoliosis. Eur Spine J. 23(12):2594-602, 2014
                                                                                          3. Waldt S et al: Measurements and classifications in spine imaging. Semin Musculoskelet Radiol. 18(3):219-27, 2014
                                                                                          4. Hresko MT: Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med. 368(9):834-41, 2013
                                                                                          5. Wybier M et al: Musculoskeletal imaging in progress: the EOS imaging system. Joint Bone Spine. 80(3):238-43, 2013
                                                                                          6. Westrick ER et al: Adolescent idiopathic scoliosis: 5-year to 20-year evidence-based surgical results. J Pediatr Orthop. 31(1 Suppl):S61-8, 2011
                                                                                          7. Kim H et al: Scoliosis imaging: what radiologists should know. Radiographics. 30(7):1823-42, 2010
                                                                                          8. Weinstein SL et al: Adolescent idiopathic scoliosis. Lancet. 371(9623):1527-37, 2008
                                                                                          9. Arlet V et al: Congenital scoliosis. Eur Spine J. 12(5):456-63, 2003
                                                                                          10. Daffner SD et al: Adult degenerative lumbar scoliosis. Am J Orthop. 32(2):77-82; discussion 82, 2003
                                                                                          11. Ahn UM et al: The etiology of adolescent idiopathic scoliosis. Am J Orthop. 31(7):387-95, 2002
                                                                                          12. Berven S et al: Neuromuscular scoliosis: causes of deformity and principles for evaluation and management. Semin Neurol. 22(2):167-78, 2002
                                                                                          13. Cassar-Pullicino VN et al: Imaging in scoliosis: what, why and how? Clin Radiol. 57(7):543-62, 2002
                                                                                          14. Do T: Orthopedic management of the muscular dystrophies. Curr Opin Pediatr. 14(1):50-3, 2002
                                                                                          15. Geijer H: Radiation dose and image quality in diagnostic radiology. Optimization of the dose-image quality relationship with clinical experience from scoliosis radiography, coronary intervention and a flat-panel digital detector. Acta Radiol Suppl. 43(427):1-43, 2002
                                                                                          16. Jones KB et al: Spine deformity correction in Marfan syndrome. Spine. 27(18):2003-12, 2002
                                                                                          17. Lenke LG et al: Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment? Spine. 27(6):604-11, 2002
                                                                                          18. Redla S et al: Magnetic resonance imaging of scoliosis. Clin Radiol. 56(5):360-71, 2001
                                                                                          19. Thomson JD et al: Scoliosis in cerebral palsy: an overview and recent results. J Pediatr Orthop B. 10(1):6-9, 2001
                                                                                          20. Jaskwhich D et al: Congenital scoliosis. Curr Opin Pediatr. 12(1):61-6, 2000
                                                                                          21. Lowe TG et al: Etiology of idiopathic scoliosis: current trends in research. J Bone Joint Surg Am. 82-A(8):1157-68, 2000
                                                                                          22. Mohaideen A et al: Not all rods are Harrington - an overview of spinal instrumentation in scoliosis treatment. Pediatr Radiol. 30(2):110-8, 2000
                                                                                          23. Roach JW: Adolescent idiopathic scoliosis. Orthop Clin North Am. 30(3):353-65, vii-viii, 1999
                                                                                          24. Oestreich AE et al: Scoliosis circa 2000: radiologic imaging perspective. I. Diagnosis and pretreatment evaluation. Skeletal Radiol. 27(11):591-605, 1998
                                                                                          25. Oestreich AE et al: Scoliosis circa 2000: radiologic imaging perspective. II. Treatment and follow-up. Skeletal Radiol. 27(12):651-6, 1998
                                                                                          26. Kim HW et al: Spine update. The management of scoliosis in neurofibromatosis. Spine. 22(23):2770-6, 1997
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