E5220. Throwing a Curve Ball: Basics of Pediatric Scoliosis
Authors
Amir Hassankhani;
Mayo Clinic - Rochester
Melika Amoukhteh;
Mayo Clinic - Rochester
Sherief Ghozy;
Mayo Clinic - Rochester
David Kallmes;
Mayo Clinic - Rochester
Lindsay Everett;
University of Louisville School of Medicine
Vesna Kriss;
Norton Children's Hospital
Background
Scoliosis refers to lateral deviation of the spine, often with concomitant vertebral rotation. Abnormal curvature of the spine is classified by origin with the three most common etiologies being congenital, idiopathic, and neuromuscular. Many cases are diagnosed during adolescence, particularly idiopathic, based on physical examination findings and radiographic measurements. Because of the potential for curve progression, patients with scoliosis are evaluated regularly with follow-up imaging and may require surgical correction to prevent secondary morbidity including progressive spinal deformity and restrictive lung changes.
Educational Goals / Teaching Points
1. Describe the three most common etiologies of scoliosis and recognize the radiographic indicators of origin. 2. Demonstration of scoliotic curve type/direction on plain spinal radiograph and measurement of the Cobb angle. 3. Use of Risser Scale and other patient demographics to predict likelihood of curve progression. 4. Communicate imaging findings and anatomic anomalies for surgical planning/intervention.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This educational exhibit will demonstrate proper imaging technique for the diagnosis of scoliosis in pediatric patients. Patient positioning, direction of beam projection, and understanding of full-spine artifact are necessary for an adequately diagnostic film. We will focus primarily on accurate Cobb angle measurement, radiographic evidence of scoliotic etiology, and indicators of potential worsening spinal curvature. Although spinal deviation is the primary focus, other bony features captured on radiographs, such as skeletal maturity and any variation in normal anatomy, can help guide follow-up and treatment measures in these patients.
Conclusion
General radiologists may encounter pediatric scoliosis at initial diagnosis or during its progression through adolescence into adulthood. Recognizing the radiographic findings of spinal curve etiology, severity, and skeletal maturity is important for appropriate clinical management and potential surgical planning.
