Trunk asymmetry and screening for scoliosis: a longitudinal cohort study of pubertal schoolchildren

Abstract

A cohort of children was followed‐up annually from an average age of 10.8–13.8 years to assess various measures of trunk asymmetry for their predictive value in the screening of scoliosis. Of 1060 children, 855 (80.7%) participated in the final examination. Trunk asymmetry was measured by the forward bending test and moire topography. A posteroanterior standing radiograph of the spine was taken of those 250 (29.2%) children who had a trunk hump 8 mm. Only 8.3% of the children were found to be symmetric (hump 0–2 mm) in the forward bending test: 65.5% had a hump of 3–7 mm and 26.2% had a hump 8 mm at 13.8 years. Also, moiré fringe asymmetry proved to be common (prevalence of asymmetry > 1 fringe 47.3%), but its correlations with rib hump (r= 0.16) and Cobb angle (r= 0.12) were low. At the final examination, the prevalence of scoliosis (Cobb angle 10°) was 9.2%. Two girls (0.2%) needed brace treatment. The forward bending test is preferable to moiré topography in screening for scoliosis, and a hump size of 6 mm at an average age of 10.8 years is the nearest to optimal as a screening threshold. Copyright © 1993, Wiley Blackwell. All rights reserved