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Get out your protractors: Measuring curve angles

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  • Get out your protractors: Measuring curve angles

    Clear detailed article about the radiographic details of scoliosis - measuring curves, classifying, identifying major/minor, etc.

    http://radiographics.rsna.org/content/30/7/1823.long

    One part of the classification discussion surprised me, and that was the description of classification by age. I'd understood that 10 years was the cutoff between juvenile and adolescent idiopathic, and that there was a third category for infantile idiopathic, but this article breaks the classification into only two groups and sets the age boundary at 5:

    "With regard to juvenile idiopathic scoliosis, the age range is arbitrary; when patients are dichotomized around a cutoff of 6 years of age, the disease features in those aged 3–6 years resemble infantile idiopathic scoliosis, whereas the disease features in those aged 6–10 years more closely resemble adolescent idiopathic scoliosis. Hence, it seems rational to consider early juvenile idiopathic scoliosis identical to infantile idiopathic scoliosis that is diagnosed late (25)."

    They go on to say that recent increases in MRI imaging are reclassifying many of what used to be called JIS cases as non-idiopathic (so, not IS cases at all).

    "Furthermore, the use of MR imaging to evaluate scoliosis resulted in an increase in the number of preadolescent patients in whom an underlying cause of scoliosis was identified, findings that prompted questions regarding the merits of the diagnostic category of juvenile idiopathic scoliosis (2) (Fig 7). Hence, there is increasing acceptance for classifying idiopathic scoliosis of the immature spine as either early- or late-onset (2). The cutoff usually used to divide these two types of scoliosis is the age of 5 years, because of the higher risk of cardiopulmonary complications in children who develop large curves before this age (2,7)."
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