Clinical presentation

Clinical presentation

On clinical examination, patients have shoulder height asymmetry and shift of the trunk. On forward bending, a back ‘hump’ or prominence may occur with rotation of the spine. From the side, patients may have a normal appearance or a hypokyphosis of the thoracic spine. On coronal radiographs, there is a lateral curvature of the spine with a Cobb angle >10^o and vertebral rotation. The lateral radiographs may show hypokyphosis. MRI is not routinely performed but should be done if there is suspicion of neurologic abnormality on physical examination, significant back pain or an atypical curve pattern. Atypical curves include short and angular curves, long C-shaped curves, left-sided thoracic curves and right-sided lumbar curves.