INTRO SCOLIOSIS

ADULT SCOLIOSIS TEMPLATE                                 Donna Magid MD  2025 ©

EXAM:  XR Scoliosis 2 views (occasionally 1 vw…composite views are ‘one view”.  If Bending, ‘4 views”)

INDICATION: Scoliosis (or ‘Post-op” or…)

COMPARISON: Date (or may use “Partial comparison from sagittal reformatted CT/MR/Chest”)

FINDINGS: (X) pairs thoracic ribs, (Y) lumbar-type vertebral bodies (esp if no old images)

     FRONTAL:  Standing/Supine/Seated (if Standing & Supine, comment “decreases/no change”, supine)

             (R,L) Thoracic curve

             (R/L) Thoracolumbar curve

             (R/L) Lumbar curve

             (R/L) Lumbosacral curve (if applicable)

             Coronal Plane balance (Maintained/< 4 cm/> 4 cm imbalance

      LATERAL: Thoracic kyphosis

            Lumbar flattening

            Sagittal plane balance (Maintained/<4 cm/>4 cm imbalance)

(If lateral bending views: “On bending to R…On bending to L… increases/decreases/no change”)

Hardware:  Posterior instrumentation/Anterior implants changed/unchanged/appearing

             No evidence of hardware motion or loosening/describe change/abnormality/separated rods

Apparently changed/unchanged since….. See clinician’s measurements

Spondylosis/Posterior facet arthritis/spondylolisthesis present/unchanged/progressing since…

No evidence of compression fx… or Compression/deformity of ….. unchanged/progressing

IMPRESSION:  No significant change. See clinician’s measurements (This is for insurance purposes—if clinician requests measurements use Cobb technique, see Teamrads.com).  (Eos) scoliosis technique which reduces detail to reduce dose. Follow up as clinically indicated.

TIPS

DO NOT make key images—We do not document curve measurements, usually, because of potential insurance issues when clinician’s measurements even minimally different from ours (our index case of same, discrepancy was well within +/- 2 SD but insurance balked at subsequent surgery payment) , Sadly, one often still has to make the measurements to accurately state ‘Not definitely changed from…”Slightly increasing…see clinician measurements.”

Eos resolution is far worse than composite (stitched) images, and prone to odd wavy motion artifacts; check old images. Clinicians get total-body images to assess extent that hips/knees contribute to spine.

TEMPLATES cannot anticipate every scenario/change/concern; add descriptors or concerns as judged appropriate.