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Evaluation of leg lengths
4%
140/3909
Assessment of abdominal reflexes
3%
124/3909
Evaluation of waist asymmetry
109/3909
Evaluation for café-au-lait spots
2%
72/3909
MRI
88%
3443/3909
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Figures A and B depict a standing PA and lateral of a 13-year-old-girl with a right-sided thoracic curve of 18 degrees with an associated thoracolumbar curve. An adequate physical exam includes an evaluation of spinal balance, leg lengths, shoulder height, waist asymmetry, café-au-lait spots, foot deformities and reflexes. An MRI is not part of the initial evaluation in patients with idiopathic scoliosis without red flags or abnormal curve types. Typical indications for MRI include patients with a left thoracic curve, abnormal reflexes, rapid curve progression, neurologic symptoms, excessive kyphosis and foot abnormalities. Based on her skeletal maturity, curve magnitude, and menarche status, the risk of curve progression is low. In females, the onset of menses typically occurs one year after peak height velocity. In this scenario, treatment can consist of observation with further follow-up.
3.9
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