{"id":13479,"date":"2023-10-05T20:58:20","date_gmt":"2023-10-05T20:58:20","guid":{"rendered":"https:\/\/ro.cvot.md\/diagnosticul-scoliozei\/"},"modified":"2025-10-05T20:45:52","modified_gmt":"2025-10-05T20:45:52","slug":"diagnosis-of-scoliosis","status":"publish","type":"page","link":"https:\/\/ro.cvot.md\/en\/coloana-vertebrala\/diagnosis-of-scoliosis\/","title":{"rendered":"Diagnosis of Scoliosis"},"content":{"rendered":"\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"Emisiunea &quot;Doctorii&quot;. Invitat ast\u0103zi Nicolai Shavga.\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/g1UUfiry8P4?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p>The term <strong>&#8220;scoliosis&#8221;<\/strong> originates from the Greek word meaning <em>&#8220;curved&#8221;<\/em>, which accurately reflects the nature of the condition. Scoliosis is considered one of the most complex challenges in modern orthopedics. It is characterized by a combination of <strong>typical functional, morphological, and radiological changes<\/strong> in the <strong>spine<\/strong>, <strong>rib cage<\/strong>, <strong>pelvis<\/strong>, and the <strong>positioning of internal organs<\/strong>.<\/p>\n\n\n\n<p>According to various studies, the <strong>prevalence of scoliosis among children<\/strong> ranges from <strong>5% to 14%<\/strong>. Based on epidemiological research conducted by the National Institute for Child and Mother Health in Moldova (2010), the <strong>prevalence of scoliosis in the Republic of Moldova<\/strong> reaches <strong>5.2%<\/strong> of all musculoskeletal disorders.<\/p>\n\n\n\n<p>Some researchers report that the <strong>average life expectancy of untreated patients with severe forms of scoliosis<\/strong> is <strong>only 35\u201340 years<\/strong>.<\/p>\n\n\n\n<p><strong>Definition<\/strong><\/p>\n\n\n\n<p><strong>Scoliosis (scoliotic disease)<\/strong> is a <strong>lateral curvature of the spine<\/strong> accompanied by <strong>vertebral rotation<\/strong>. A distinctive feature of scoliosis is its <strong>progressive nature<\/strong>, which is closely linked to the child\u2019s age and growth. Even in its early stages, <strong>true scoliosis<\/strong> involves <strong>structural spinal deformities<\/strong> that <strong>persist regardless of body position or physical load<\/strong>.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"500\" height=\"298\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/2-3.jpg\" alt=\"\" class=\"wp-image-11962\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/2-3.jpg 500w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/2-3-300x179.jpg 300w\" sizes=\"(max-width: 500px) 100vw, 500px\" \/><\/figure><\/div>\n\n\n<p><strong>Diagnosis of Scoliosis<\/strong><\/p>\n\n\n\n<p><strong>Early diagnosis<\/strong> plays a crucial role in the successful treatment of scoliosis and in preventing severe progression. Diagnostic steps typically include:<\/p>\n\n\n\n<p><strong>1. Clinical Examination<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Postural asymmetry (shoulders, scapulae, waistline, pelvis)<\/li>\n\n\n\n<li>Adam\u2019s Forward Bend Test to detect spinal rotation and rib hump<\/li>\n\n\n\n<li>Palpation of the spinal column for curvature or rigidity<\/li>\n\n\n\n<li>Neurological assessment to rule out secondary causes<\/li>\n<\/ul>\n\n\n\n<p><strong>2. Radiographic Imaging<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>X-rays (anteroposterior and lateral views)<\/strong> are the gold standard<\/li>\n\n\n\n<li><strong>Cobb angle measurement<\/strong> determines the degree of spinal curvature:\n<ul class=\"wp-block-list\">\n<li>Mild: 10\u201320\u00b0<\/li>\n\n\n\n<li>Moderate: 20\u201340\u00b0<\/li>\n\n\n\n<li>Severe: >40\u00b0<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Spinal rotation<\/strong> and vertebral wedging may also be visualized<\/li>\n<\/ul>\n\n\n\n<p><strong>3. Advanced Imaging (if needed)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>MRI<\/strong>: indicated in cases of rapid progression, neurological symptoms, or congenital anomalies<\/li>\n\n\n\n<li><strong>CT scan<\/strong>: used for detailed bone analysis or pre-surgical planning<\/li>\n<\/ul>\n\n\n\n<p><strong>4. Functional Tests<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Assessment of spinal flexibility and posture<\/li>\n\n\n\n<li>Gait analysis and evaluation of muscle tone<\/li>\n\n\n\n<li>Respiratory function tests in severe thoracic scoliosis<\/li>\n<\/ul>\n\n\n\n<p><strong>5. Monitoring Progression<\/strong><\/p>\n\n\n\n<p>Regular monitoring is essential, especially during growth spurts. X-rays are repeated every <strong>6\u201312 months<\/strong>, depending on the severity and progression rate.<\/p>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"210\" height=\"380\" data-id=\"11963\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/3-1.jpg\" alt=\"\" class=\"wp-image-11963\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/3-1.jpg 210w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/3-1-166x300.jpg 166w\" sizes=\"(max-width: 210px) 100vw, 210px\" \/><figcaption class=\"wp-element-caption\"><br><em><strong>11 \u043b\u0435\u0442<\/strong><\/em><\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"211\" height=\"378\" data-id=\"11964\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/4-1.jpg\" alt=\"\" class=\"wp-image-11964\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/4-1.jpg 211w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/4-1-167x300.jpg 167w\" sizes=\"(max-width: 211px) 100vw, 211px\" \/><figcaption class=\"wp-element-caption\"><br><br><em><strong>13 \u043b\u0435\u0442<\/strong><\/em><\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"207\" height=\"377\" data-id=\"11965\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/5-1.jpg\" alt=\"\" class=\"wp-image-11965\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/5-1.jpg 207w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/5-1-165x300.jpg 165w\" sizes=\"(max-width: 207px) 100vw, 207px\" \/><figcaption class=\"wp-element-caption\"><br><em><strong>15 \u043b\u0435\u0442<\/strong><\/em><\/figcaption><\/figure>\n<\/figure>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-2 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"302\" height=\"245\" data-id=\"11966\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/6-1.jpg\" alt=\"\" class=\"wp-image-11966\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/6-1.jpg 302w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/6-1-300x243.jpg 300w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/6-1-370x300.jpg 370w\" sizes=\"(max-width: 302px) 100vw, 302px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"315\" height=\"247\" data-id=\"11967\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/7.gif\" alt=\"\" class=\"wp-image-11967\"\/><\/figure>\n<\/figure>\n\n\n\n<p><strong>Recognition of scoliosis is extremely important at the early stages of its development, because only timely started treatment can prevent the progression of the curvature. It is important to know at what age the spinal deformity was noticed and how it progressed.<\/strong><\/p>\n\n\n\n<p>In patients with scoliosis, pelvic tilt, lateral deviation of the torso, and lateral curvature of the spine are observed. When scoliosis is present, one shoulder is higher than the other, which can be easily determined by the level of the scapulae and clavicles. The scapula on the concave side of the curvature is closer to the spinous processes than on the convex side. The distance from the top of the spinous process of the seventh cervical vertebra (C7) to the scapular angle is smaller on the convex side of the curvature than on the concave side. The degree of stability of the deformity is assessed by gently pulling the head.<\/p>\n\n\n\n<p><strong>X-rays must be taken in two projections, both lying down and standing up.<\/strong> The severity of scoliosis is characterized by the degree of changes. Patients with congenital scoliosis often have changes in the cardiovascular and respiratory systems. If scoliosis develops in the thoracic spine, the deformed vertebrae pull the attached ribs along with them, causing deformation of the chest and development of a rib hump.<\/p>\n\n\n\n<p>An orthopedic specialist\u2019s focus during scoliosis treatment should be on identifying and correcting the primary curve, which is the main task. The longer scoliosis exists, the more stable and fixed it becomes, and the harder it is to correct the deformity.<\/p>\n\n\n\n<p>The progression of scoliosis depends on the patient\u2019s age, type, degree of curvature, and cause. The greatest progression is observed during the child\u2019s rapid growth phase and usually stops when growth ceases. Therefore, the earlier the disease starts, the higher the risk of deformity progression; the later it starts, the less chance there is of significant scoliosis development.<\/p>\n\n\n\n<p>Scoliosis progression continues with the child\u2019s growth and reaches its maximum during puberty \u2014 at ages 11\u201313 in girls and 14\u201316 in boys. From this age, the progression rate gradually decreases and stops by the end of skeletal growth, approximately between 17 and 20 years.<\/p>\n\n\n\n<p><strong>Scoliosis is a disease of the growing organism!<\/strong><\/p>\n\n\n\n<p>The main cause of deformity progression is the asymmetric growth of the vertebra.<\/p>\n\n\n\n<p>The increase in scoliotic deformity in adults is caused by age-related changes in the bone tissue and degenerative changes in the intervertebral discs. Essentially, this is the \u201csettling\u201d or collapse of the deformed spine.<\/p>\n\n\n\n<p><strong>Classification of Scoliosis According to V. D. Chaklin:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Grade I<\/strong>: Characterized by a lateral deviation up to 10\u00b0 and an initial degree of torsion, detectable by X-ray.<\/li>\n\n\n\n<li><strong>Grade II<\/strong>: Manifested by torsion and the presence of compensatory curves. Clinically, a muscular ridge and a small rib hump caused by vertebral torsion are observed. Lateral deviation ranges from 11\u00b0 to 24\u00b0.<\/li>\n\n\n\n<li><strong>Grade III<\/strong>: More pronounced deformity with lateral deviation between 25\u00b0 and 40\u00b0, accompanied by a large rib hump. Radiologically, wedge-shaped vertebrae are seen at the apex of the curvature.<\/li>\n\n\n\n<li><strong>Grade IV<\/strong>: Severe trunk deformity characterized by thoracic kyphoscoliosis, pronounced rib hump, pelvic deformation, and trunk deviation. The primary curve angle exceeds 41\u00b0.<\/li>\n<\/ul>\n\n\n\n<p><strong>Risser Sign (Risser Test)<\/strong><\/p>\n\n\n\n<p>The <strong>Risser sign<\/strong> is an objective clinical indicator used to assess the growth potential of the spine and to estimate skeletal maturity. It is based on the appearance of ossification centers on the iliac crest, visible on pelvic X-rays. These ossification points are among the last growth plates to close in the human body.<\/p>\n\n\n\n<p>On an X-ray, these ossification zones look like a faint \u201ccloud\u201d floating above the iliac crest. When this &#8220;cloud&#8221; disappears\u2014meaning it has fused with the bone\u2014it indicates that skeletal growth has ended. This usually occurs around ages 16-18 in boys and slightly earlier in girls, before age 16.<\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"99\" height=\"146\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/11.jpg\" alt=\"\" class=\"wp-image-11971\"\/><figcaption class=\"wp-element-caption\">\u041a\u043e\u043c\u0431\u0438\u043d\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u0441\u0442\u0435\u043d\u043e\u0437.<\/figcaption><\/figure><\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"125\" height=\"109\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/10\/12.jpg\" alt=\"\" class=\"wp-image-11972\"\/><figcaption class=\"wp-element-caption\">\u041c\u0438\u0435\u043b\u043e\u0438\u0448\u0435\u043c\u0438\u044f<\/figcaption><\/figure><\/div><\/div>\n<\/div>\n\n\n\n<p><strong>Ossification begins at the anterior superior iliac spine and progresses posteriorly.<\/strong> The iliac crest is divided into four parts, and the degree of skeletal maturity is determined by how many of these parts are ossified:<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><td><strong>Risser Stage<\/strong><\/td><td><strong>Description<\/strong><\/td><\/tr><\/thead><tbody><tr><td><strong>0<\/strong><\/td><td>Apophysis not visible<\/td><\/tr><tr><td><strong>1<\/strong><\/td><td>Beginning of lateral ossification<\/td><\/tr><tr><td><strong>2<\/strong><\/td><td>Ossification of half the iliac crest<\/td><\/tr><tr><td><strong>3<\/strong><\/td><td>Beginning of fusion of the apophysis with iliac wing<\/td><\/tr><tr><td><strong>4<\/strong><\/td><td>Half fusion of the apophysis with iliac wing<\/td><\/tr><tr><td><strong>5<\/strong><\/td><td>Complete fusion of the apophysis with iliac wing<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stage 3<\/strong> means approximately 75% ossification of the iliac crest.<\/li>\n\n\n\n<li><strong>Stage 4<\/strong> means all four parts are ossified.<\/li>\n\n\n\n<li><strong>Stage 5<\/strong> means complete fusion of the ossified apophysis with the iliac bone.<\/li>\n<\/ul>\n\n\n\n<p><strong>Cobb Method<\/strong><\/p>\n\n\n\n<p>Among the many methods for measuring the curvature angle of scoliosis, the <strong>Cobb method<\/strong> is the most widely used. It is based on determining the angle formed by the end vertebrae of the curvature arc.<\/p>\n\n\n\n<p>On a frontal X-ray, lines are drawn along the upper endplate of the uppermost vertebra and the lower endplate of the lowermost vertebra of the scoliotic curve. Then, perpendicular lines are drawn from these two lines, and the angle formed between these perpendiculars is measured in degrees. This angle represents the degree of spinal curvature.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>For small curvatures, an additional angle between the perpendicular lines to these reference lines may be measured.<\/li>\n\n\n\n<li>If necessary, <strong>computed tomography (CT)<\/strong> scans can be performed to get more detailed imaging.<\/li>\n<\/ul>\n\n\n\n<p><strong>Example:<\/strong><br>X-ray and CT of a 16-year-old patient diagnosed with idiopathic scoliosis, Grade 4, with a Cobb angle of 125 degrees.<\/p>\n\n\n\n<p><strong>Scoliosis Severity Classification by Cobb Angle:<\/strong><\/p>\n\n\n\n<p><strong>Grade 4:<\/strong> Very severe scoliosis<\/p>\n\n\n\n<p><strong>Grade 1:<\/strong> Mild scoliosis<\/p>\n\n\n\n<p><strong>Grade 2:<\/strong> Moderate scoliosis<\/p>\n\n\n\n<p><strong>Grade 3:<\/strong> Severe scoliosis<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The term &#8220;scoliosis&#8221; originates from the Greek word meaning &#8220;curved&#8221;, which accurately reflects the nature of the condition. Scoliosis is considered one of the most complex challenges in modern orthopedics. It is characterized by a combination of typical functional, morphological, and radiological changes in the spine, rib cage, pelvis, and the positioning of internal organs. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":13480,"parent":13485,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-13479","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Diagnosis of Scoliosis - Asocia\u0163ia Ob\u015fteasc\u0103 &#039;&#039;HEALTHY SPINE&#039;&#039;<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ro.cvot.md\/en\/coloana-vertebrala\/diagnosis-of-scoliosis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Diagnosis of Scoliosis - Asocia\u0163ia Ob\u015fteasc\u0103 &#039;&#039;HEALTHY SPINE&#039;&#039;\" \/>\n<meta property=\"og:description\" content=\"The term &#8220;scoliosis&#8221; originates from the Greek word meaning &#8220;curved&#8221;, which accurately reflects the nature of the condition. Scoliosis is considered one of the most complex challenges in modern orthopedics. It is characterized by a combination of typical functional, morphological, and radiological changes in the spine, rib cage, pelvis, and the positioning of internal organs. 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