IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Idiopathic scoliosis

Case contributed by Leonardo Lustosa
Diagnosis certain

Presentation

Recent neck pain. Known history of adolescent idiopathic scoliosis.

Patient Data

Age: 20 years
Gender: Female
x-ray

Scoliosis with a primary lumbar curvature to the left (24.44°) and a secondary thoracic curvature to the right (13.56°). No pelvic obliquity.

(See image below for angle measurements)

Annotated image

Measurement of the curves using the Cobb method.

Case Discussion

Scoliosis is commonly referred to as the lateral deviation of the spine. Although this is correct, the actual deformity isn't limited to the coronal plane, there is a rotational component as well, making the true curvature three-dimensional.

Idiopathic scoliosis is the most common form of the condition, which can be further classified regarding the age of onset, with adolescent idiopathic scoliosis being the most common subtype (between 10 years of age and skeletal maturity).

Measuring the curvatures is essential in the evaluation of a scoliotic patient. The method of Cobb is the recommended technique. To measure the curve:

  1. determine the superior and inferior end vertebrae

  2. draw a line tangential to the superior end plate or pedicles of the superior end vertebra

  3. draw a line tangential to the inferior end plate or pedicles of the inferior end vertebra

  4. if the lines intersect, measure the angle between the; if they do not intersect inside the image, draw lines perpendicular to the previous ones and measure the angle between them

The end vertebrae are those most tilted toward the concavity.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.