Skip to Main Content




  • Kyphoscoliosis




  • 737.30 Scoliosis (and kyphoscoliosis) idiopathic




  • M41.20 Other idiopathic scoliosis, site unspecified




  • 4B: Impaired Posture



A 16-year-old girl is referred to your outpatient physical therapy clinic. The patient comes with her mom. The patient states she has been going to cheerleading practice and is having back pain. The referring physician told her she had scoliosis with a Cobb angle of 27 degrees. They do a lot of stretching in cheerleading practice, but she is having difficulty with the backward bends. She is starting to have some instability in the thoracic spine with localized pain and erector spinae spasms.




  • Three-dimensional curvatures of the spine and trunk

    • Lateral curve is an S- or C-shaped curve in the sagittal plane

    • Torsional component with vertebrae rotating toward the convexity

    • Anteroposterior distortion leads to hyperkyphosis and/or hyperlordosis in the coronal plane

  • Functional lateral curvature of the spine, typically reversible

  • Structural lateral curvature of the spine, fixed

    • Most commonly idiopathic

    • May be present in conjunction with another condition

    • 80% to 85% are idiopathic

    • Congenital

      • Hemi-vertebrae malformation

  • Infantile onset: Younger than 3 years

  • Juvenile onset 3 to 9 years old

  • Adolescent idiopathic scoliosis (AIS) onset 10 to 18 years old

  • Adult onset: Older than 18 years

  • AIS is the most common form and occurs in otherwise healthy children during puberty (80%–85% of cases)

  • Relatively benign condition

  • Named for the side of the convexity of the lateral curve (right, dextroscoliosis; left, levoscoliosis)

  • Degree of curvature most commonly defined by the Cobb method, radiographically

  • Increased risk of curve progression during growth spurts in adolescents

FIGURE 140-1

Adam’s forward bending test. (A) No visible rib hump, negative test. (B) Visible rub hump, positive test. (From Lawry GV. Systematic Musculoskeletal Examinations. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
Essentials of Diagnosis

  • Adam’s forward bending test

    • Patient stands with back to the clinician and then actively bends forward toward the floor.

    • Examination reveals a rib hump, which represents the posteriorly displaced rib angles due to vertebral rotation on the convex side of the curve.

      • Functional: During forward bending, the rib hump disappears with ipsilateral side bending.

      • Structural: During forward bending, the rib hump persists with ipsilateral side bending.

    • Inclinometer measuring device may be utilized to clinically document progression or regression of curve without radiation exposure.

  • X-rays (occiput to sacrum) used to define severity of curve.

    • Anteroposterior view with Cobb angle measurements

      • A perpendicular line at the top of the vertebral body of the superior most acutely angles vertebral segment intersecting a similar line at ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.