> Patient and Family > Adult Idiopathic Scoliosis
Front and side full-length standing X-rays that include all segments of the spine as well as the pelvis and hips are essential in the diagnostic evaluation of adults with spinal deformity (Figure 1A and B)
. From such X-rays the segmental alignment, regional curvatures and global balance (overall alignment) can be measured. It is important that the hips and knees are straight for the side X-rays to truly understand the deformity (Figure 1C and D)
. Focal imaging studies may be necessary to assess for instability (flexion-extension radiographs). Advanced imaging studies (such as MRI or CT myelography) may be needed to assess patients with lower extremity symptoms or other neurologic signs or symptoms (Figure 2)
Figure 1: Front and side X-rays showing the entire spine and hips. Make sure the knees and hips are straight on the side X-rays. shows the patient in the compensated (knees bent) position, while shows them standing with their knees straight.
Figure 2: A front view of the lumbar spine. Yellow arrows show “olisthesis” (advanced rotation) and green arrows show tight regions causing pinched nerves. Myelogram – with the introduction of dye, the nerves can be seen on X-ray. The blue arrow shows a “dent” – pinched nerve blocking the dye. MRI of L4-L5 showing spinal stenosis (pinched nerves). CT myelogram of the same level. Without myelogram contrast, it is difficult to see nerves on CT.