Learning objectives
To understand what should be included when reporting a radiograph for paediatric scoliosis.
To learn how to correctly measure the Cobb angle.
To recognise vertebral developmental anomalies.
To recognise common surgical interventions for scoliosis and their complications.
Background
INTRODUCTION:
Scoliosis is a common problem with an incidence of 3% of the population (reviewed in 1,
2) and is important both functionally and cosmetically.
Pulmonary function may be affected in severe scoliosis.
A variety of surgical interventions are utilised and radiologists have an important role in detecting complications following surgical correction of scoliosis.
The term scoliosis was first used by Hippocrates around 4BC,
from the Greek 'σκολιοσ',
meaning ‘crooked’.
Scoliosis is defined as one or more lateral rotatory curves of the spine in the...
Findings and procedure details
We undertook adepartmental audit of the reporting of radiographs for paediatric scoliosisandfound considerable variability in the content and accuracy of the reports.
Following discussionwith ourpaediatric spinal surgeons,
we established standard criteria that should be included in the radiologist’s report of scoliosis radiographs.
Particular problems may arise if the radiologist reports a significantly different Cobb angle to the paediatric surgeon.
Radiologists shouldreport the side of the scoliosis,
region of the spine affected,
apical vertebra,
correctly measured Cobb angle,
spinal developmental anomalies and Risser stage.
An audit...
Conclusion
At our tertiary referral centre,
further education is planned for the reporting of paediatric scoliosis radiographs,
with respect to accurate reporting of the side,
region,
apex and Cobb angle of the scoliosis.
Risser stage is rarely reported in our centre,
partially because the iliac crests are not always adequately included on the radiograph.
There is ongoing discussion as to whether radiologists will include Risser staging in their reports,
or whether this will be determined by the Paediatric Spinal Surgeon.
Further investigation is planned into the...
Personal information
Emma Gerety is a final year trainee in Clinical Radiology specialising in musculoskeletal radiology,
with a special interest in paediatric musculoskeletal imaging and trauma imaging.
John Crawford is a consultant orthopaedic spinal surgeon,
specialising in paediatric spinal surgery.
Jacqueline Hughes is a consultant radiologist,
specialising in paediatric radiology.
References
1.
Radiographic evaluation of scoliosis.
Malfair D,
Flemming AK,
Dvorak MF et al.AJR 2010; 194(3 suppl):S8-22.
2.
Scoliosis imaging: what radiologists should know.
Kim H,
Kim HS,
Moon ES,
Yoon CSet al.Radiographics 2010; 30(7)1823-1842.
3.
ACR-SPR-SSR practice parameter for the performance of radiography for scoliosis in children.
2014.
4.
Outline for the study of scoliosis.
Cobb JR.
In: Edwards JW,
ed.
Instructional course lectures,
vol5.
Ann Arbor,
MI: Am Acad Orth Surg 1948.
5.
The iliac apophysis; an invaluable sign in the management of scoliosis....