An In Depth Review of Scoliosis: Radiographic Imaging

A standing side view radiograph of the thoracolumbar spine is suggested if significant deformity is present in the front-to-back (sagittal) plane. Radiographs are assessed for spinal column contour and to rule out congenital, developmental, degenerative or neoplastic abnormalities. The amount of each deformity is calculated using a standard, reproducible measurement technique. An estimate of skeletal maturity is made by assessment of the growth areas at the upper pelvis and hips (Fig.6).

Figure 5. Screening PA erect

Figure 6. Risser's sign
and triradiate cartilage status

Specialized imaging studies such as (CT scans or magnetic resonance imaging (MRI)) may occasionally be needed. Magnetic resonance imaging is done to evaluate the spinal cord and spinal nerves (Fig.7).

As with all studies, MRI is done for a specific indication and correlated with clinical examination. Myelography, a radiographic study which uses an injected dye to provide contrast to study the spinal canal and its contents, has been largely replaced by magnetic resonance imaging techniques. CT scans are used to provide improved definition of abnormalities of vertebral size, shape or number (Fig.8).

Figure 7. Lateral T-L spine

Figure 8. Congenital lumbar
scoliosis - 3D CT reconstruction