Scoliosis Screening – To screen or not to screen.

Photo by Casper Nichols - Ustream.

In residency I was taught to do the Adams forward bend test for scoliosis on all adolescent physicals. I typically started at age 11 or earlier if the child is Tanner 2. I kept screening as a part of my physical for patients until they graduate from the practice and move on to the adult world. It has always felt silly screening skeletally mature teens and young adults. The scoliosis screen is expected by parents and patients. It is almost like a physical isn't complete without it.

The AAP and AAOS published guidelines in 2015 advising screening for girls twice at ages 10 and 12 and for boys once ages 13-14.

This month the USPTF  released its final statement that "evidence is insufficient on the balance of benefits and harms of screening for adolescent idiopathic scoliosis in children and adolescents aged 10 to 18". Here is a nice page for parents from USPTF and JAMA on scoliosis screening.

On the other hand, screening takes a very short time and with a phone-based app as a scoliometer - nearly free. Most all pediatricians can recall picking up severe scoliosis on a routine screening in a child who neither they personally or their family had any complaints.

After this review of guidelines and some thought I will not screen girls at age 10 and 12 and boys age 13 and 15. If a child is Tanner 2 at a earlier age - I will screen then. And then I will stop. I am sure I will have to explain to a questioning parent why I didn't do a scoliosis test but I now have the handy JAMA info sheet to handout.

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