Scoliosis: The Daily PANCE Blueprint

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Scoliosis: The Daily PANCE Blueprint

A 13-year-old girl is brought to the clinic by her parents due to concerns about her posture. On examination, she has a noticeable lateral curvature of her spine. The Adams forward bend test reveals a rib hump on the right side. Her neurological examination is normal. A scoliometer measurement shows an angle of trunk rotation (ATR) of 8°. Her body mass index (BMI) is in the 50th percentile for her age. What is the most appropriate next step in the management of this patient?

A. Referral for immediate surgical intervention
B. Prescription of a rigid brace to be worn at all times
C. Ordering a full-length posteroanterior and lateral spine radiograph
D. Initiation of physical therapy focused on spinal strengthening exercises
E. Magnetic resonance imaging (MRI) of the entire spine

Answer and topic summary

The answer is C. Ordering a full-length posteroanterior and lateral spine radiograph

This patient presents with signs suggestive of adolescent idiopathic scoliosis (AIS), characterized by a lateral curvature of the spine with associated rotation. The Adams forward bend test and scoliometer measurement are initial clinical tools used to screen for scoliosis. In this case, the patient’s angle of trunk rotation (ATR) of 8° and a BMI in the 50th percentile indicates the need for radiographic evaluation. The initial radiographic assessment for scoliosis should include standing, full-length posteroanterior and lateral views of the spine to assess the magnitude of the curve (Cobb angle) and skeletal maturity.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Spinal Disorders (PEARLS) ⇒ Scoliosis

Also covered in the Pediatric PAEA EOR topic lists