The validity of clinical examination in adolescent spinal deformities

Stud Health Technol Inform. 2002:91:123-5.


Study design: retrospective study on the accuracy and reliability of two clinical tests for scoliosis in young patients.

Aim: to evaluate the inter-observer reliability of three non-invasive clinical measurements: hump height (HH), axial trunk rotation (ATR), and distance of the spinous process from the plumb line (DP) in standing; to compare these results with the corresponding radiographic measurements, the Cobb angles (CA).

Population: 116 patients, 78 females and 38 males; 410 examinations have been performed (144 patients with brace and 266 without).

Methods: a database was created using the measurements of different clinical parameters obtained from two examiners that measured them independently and in the same conditions. The Cobb method has been used as a gold standard.

Results: our results show a very high inter-rater reliability for HH and ATR measurements. The DP shows a different inter-rater reliability for the thoracic (C7) and lumbar (L3) spine, in both cases lower than that in the frontal plane; the ICC of the thoracolumbar DP (D12) was very low. The correlation with the radiographic value was weak.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Braces
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kyphosis / classification
  • Kyphosis / diagnosis*
  • Kyphosis / therapy
  • Lordosis / classification
  • Lordosis / diagnosis*
  • Lordosis / therapy
  • Lumbar Vertebrae
  • Male
  • Observer Variation
  • Reproducibility of Results
  • Retrospective Studies
  • Scoliosis / classification
  • Scoliosis / diagnosis*
  • Scoliosis / therapy
  • Statistics as Topic
  • Thoracic Vertebrae