Scoliosis can be diagnosed with a physical examination by a school nurse, pediatrician or orthopedic surgeon. The principal sign is asymmetry of the back, as the spine bends sideways and twists. Most commonly, this is detected by noticing a hump on the ribs or flank, between the ribs and hip, after asking the child to bend forward. The tilt produced in the back can be measured in degrees by a level; seven degrees or more is considered significant for scoliosis.

Other signs of scoliosis include elevation of one shoulder compared with the other, tilting of the pelvis — which may make one leg appear shorter than the other — and a difference in the contours of the flanks.

The next step after the physical examination is an X-ray of the spine.

Certain types of scoliosis are associated with other diseases, such as kidney disease. If a child with scoliosis is suspected of having an underlying disease, other tests may be necessary. Symptoms of possible underlying disease include significant pain, pigmented markings or a hairy patch on the skin or a deformity of the foot. Tests for underlying disease may include an ultrasound to look for kidney disease and a magnetic resonance imaging (MRI) study to look for an abnormality of the nervous system.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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