How to recognize scoliosis

While recognition of the problem is much easier in little children as parents often help them to bath, dress up atc., it is much more difficult when we talk about teenagers. Especially girls do not like getting undressed in front of their parents, which makes any changes within the spine or the torso more likely to be overlooked, between 11 and 14 years old in particular, when scoliosis is most probable to develop. We should examine our child every 3-4 months.

How to examine our child, what we should pay our attention to:

We should look at the child:

• from behind
  We should check the position of the head if it is not tilted to either side, whether shoulders and blades are symmetrical and on the same level. We need to pay attention to the symmetry of so called triangles of the waist (waist indentation) and make sure neither hip sticks out too much. It is important to check the position of the spine if it’s not bent in any direction. We also need to watch gluteal folds if they are at the same height as well as the position of knees and feet. We should observe whether medial ankles of the feet are not too close together and whether the medial part of the foot not flattened.

Correct posture

Incorrect posture
lumbar scoliosis

Incorrect posture
thoracic scoliosis

• in front
  We should assess the alignement symmetry of head, shoulders, waste triangle and hips. We ask the child to take a deep breath and if there is scoliosis we’ll be able to see protruding ribs more on one side in the lower spine.

Correct posture

Incorrect posture

Incorrect posture

• looking at the side
  We should be able to see three physiological bends in a standing position: cervical lordosis (forward bend), thoracic kyphosis (backwards bend) and lumbar lordosis
  (forward bend). These curvatures can be increased or decreased.

Correct posture

Incorrect posture
flat back

Incorrect posture
concave back

• sideways, child tilted forward with loosely hanging arms
  From the very beginning of scoliosis formation thoracic kyphosis decreases and segmental spine flattening becomes noticeable (parts of spine will be less visible or even not visible at all) compared to the other segments.

Correct posture

Incorrect posture
flattened thoracic kyphosis

Incorrect posture
increased thoracic kyphosis 

• in front, child tilted forward with loosely hanging arms
  If there is thoracic scoliosis, a rib hump appears, which is caused by spine rotation on its axis and a turn of the chest. With lumbar scoliosis we will notice lumbar prominence, which is caused by rotation of vertebrae.

Correct posture

Incorrect posture
rib hump