Neuroimaging clinics of North America vol:17 pages:105-115
In the frontal plane, the normal load-bearing spine is straight. Scoliosis is a structural lateral curvature of the spine with a rotator component. A small deviation (<10°) is sometimes called asymmetry, whereas “true” scoliosis has a deviation of ≥10°. This deviation is accompanied by a rotation that is maximally at the apex of the curve. In the thoracic region, this rotation creates an asymmetry of the thoracic cage that produces the typical chest wall prominence known as the Adams sign.
Imaging in scoliosis is important. Most cases of scoliosis are idiopathic, and imaging is used routinely in monitoring the changes of the deformity that take place during growth. Imaging is also crucial in determining the underlying etiology in non-idiopathic cases of scoliosis and is used in pre- and postoperative monitoring.
Generally, scoliosis is treated by orthopedic surgeons who have special training in spinal and pediatric problems. Patients who have scoliosis may present directly to the radiology department through a primary health care physician or may be referred from the pediatric, neurology, or neurosurgery departments. Many physicians look toward the radiologist as the spinal expert. Therefore, radiologists should know the basics of scoliosis, how to perform the radiological examination, how to read these films correctly, and how to make a coherent and helpful interpretation.