impact in the long run . As per a study done with 1030 women with scoliosis exposed to an average of 8.7 x-ray radiation over a year , 11 cases of breast cancer were reported , mostly in females who were monitored for more than 30 years . This study revealed that exposure risk increased with time [ 4 ]. Apart from breast cancer , continuous exposure to radiation since an early age can cause a radiation induced cancer of the thyroid , brain skin and leukaemia [ 5 ].
To reduce the dependence on radiations , physical examinations are more frequently conducted for monitoring scoliosis . Physical examination includes the assessment of posture and body contour , such as shoulder and hip unevenness , protruding shoulder blades , rib hump , unequal leg length , assessment of physiologic maturity , gait , pain , etc . Some medical devices and tests that help in effectively screening scoliosis include the following :
1 . Adam ’ s Forward Bend Test and Angle of Trunk Rotation ( ATR ) Scoliometer Adam ’ s Forward Bending Test along with an ATR scoliometer has proved to be an effective screening tool for scoliosis . The physician observes patient ’ s spine for any scoliosis indicator such as asymmetries of vertebral column or scapula , unlevelled shoulder or hip , alignment of head with respect to the pelvis or a rib hump . To get a more affective screening technique , Adam ’ s Forward Bend Test is combined with ATR scoliometer to diagnose scoliosis . The scoliometer is placed along to spine to measure the highest point of the curve . Bunnell defined the following screening cutoff criteria [ 6 ] as :
● 0 º ≤ ATR ≤ 3 º Normal
● 4 º ≤ ATR ≤ 6 º the trunk rotation is intermediate
● 7 º ≤ ATR high possibility of having scoliosis
Figure 1 : Adams Forward Bend Test and ATR Scoliometer
Figure 2 : SHD measurement using Baseline Scoliometer
2 . Shoulder Height Difference ( SHD ) and Baseline Scoliometer Shoulder imbalance is one of the common symptoms of scoliosis . Surgeons record these differences and compare it with consecutive followups to assess the growth of curve . Imbalance in shoulder causes an irregular gait in the patient and also plays an important factor in achieving cosmesis after surgery . To be able to measure these
Before Figure 3 : Rib Hump
After
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