Which finding is indicative of idiopathic scoliosis?

Which finding is indicative of idiopathic scoliosis?

• A. Asymmetry in scapula/ribs/flanks/shoulders/hips, and improperly fitting clothes
• B. Symmetry
• C. Normal spinal alignment
• D. Pain and deformity only

Answer: (A)

Idiopathic scoliosis shows up as a lateral curvature of the spine with visible trunk asymmetry. On exam you’d notice differences in shoulder height, prominence of a scapula or rib hump, asymmetrical flanks or hips, and clothes that don’t hang evenly because the torso isn’t symmetrical. This kind of asymmetry is the key clue pointing to scoliosis, and it can be present even if there isn’t pain. Why the other ideas aren’t the hallmark: symmetry or a perfectly aligned spine would not indicate scoliosis. Pain with deformity can occur with other conditions, and scoliosis itself is often painless, especially in early stages. So the best answer is the finding of trunk asymmetry with uneven shoulders/hips and ill-fitting clothes.

Idiopathic scoliosis shows up as a lateral curvature of the spine with visible trunk asymmetry. On exam you’d notice differences in shoulder height, prominence of a scapula or rib hump, asymmetrical flanks or hips, and clothes that don’t hang evenly because the torso isn’t symmetrical. This kind of asymmetry is the key clue pointing to scoliosis, and it can be present even if there isn’t pain.

Why the other ideas aren’t the hallmark: symmetry or a perfectly aligned spine would not indicate scoliosis. Pain with deformity can occur with other conditions, and scoliosis itself is often painless, especially in early stages. So the best answer is the finding of trunk asymmetry with uneven shoulders/hips and ill-fitting clothes.