Suggested approach to the evaluation and diagnosis of adolescent idiopathic scoliosis (AIS)

BMI: body mass index.
* Scoliometer readings in children with BMI ≥85^th percentile for age and sex are typically lower than in children with BMI <85^th percentile for age and sex.
¶ Standing, full-length (C7 to the sacrum and iliac crest), posteroanterior (PA), and lateral views of the spine.
Δ Neurologic findings include (but are not limited to) headache, neck pain, intrinsic wasting of the hands, absent abdominal reflex, asymmetric lower extremity atrophy, pes cavus, and midline skin lesions.
◊ Radiographic findings of congenital scoliosis or intraspinal pathology include (but are not limited to) wedged vertebrae, hemivertebrae, vertebral body lucency, erosion of the pedicles, and increased kyphosis. Refer to UpToDate topic on clinical features and diagnosis of adolescent idiopathic scoliosis for details.
§ Other indications for MRI of the spine include left-sided thoracic curve, male sex, and increase in Cobb angle of ≥10° per year, but these indications are controversial.