Scoliosis can often be determined by a visual examination. When viewing the spine from behind, a lack of trunk symmetry may be observed.
Scoliosis is classified as mild, moderate or severe. Depending on each unique case, scoliosis may cause limited problems, or many. The combination of lateral curvature and vertebral rotation often results in a “rip hump” in the thoracic spine. (We prefer the term ‘prominence’. This prominence occurs when spinal vertebrae rotate toward the concave side of the curve, pushing the ribs dorsally (backwards). The result is a prominence on the convex side of the spinal curve. This prominence may be viewed from the rear when a person bends forward from the waist with the spine parallel to the floor with feet together, knees straight, and arms hanging down. This simple test for scoliosis is known as the Adam’s Forward Bend Test.
Physicians should perform other tests, including x-rays, to determine if scoliosis is present:
How to Check for Scoliosis (things to look for)
- spinal asymmetry
- unlevel shoulders
- shoulder asymmetry
- unlevel hips, with/without one-sided hip prominence
- head does not line up with pelvis
- rib prominence
With scoliosis, the spine must be considered from a lateral (side) view as well. From a lateral (sagittal) perspective a normal spine has four curves: cervical, thoracic, lumbar and sacral. Scoliosis frequently presents with deviations in the typical lateral curve patterns. For instance, from the side it is normal for the thoracic spine to have a slight arcing ‘C’ pattern (kyphosis), but with scoliosis there may be a deviation from normal: if the arc is especially pronounced, it may be hyperkyphosis. If there is a flattening of the thoracic spine, the patient may have hypokyphosis. The lower back or lumbar spine should have a mildly inverse ‘C’ arc known as lordosis. An above normal variation of the curve pattern, again, from the side, in the low back is known as hyperlordosis. If there is a flattening in the lumbar spine this is known as hypolordosis.
These variables in the way scoliosis presents contributes to making each scoliosis case unique and requires the expertise of a scoliosis expert. A majority of scoliosis patients are hypokyphotic in the thoracic spine and hypolordotic in the lumbar spine.