Radiographic Synopsis Technique

• Erect radiographs of the entire spine on AP projection. A lateral view may be needed to evaluate accompanying kyphosis (idiopathic scoliosis).

• Supplementary detailed supine and oblique projections are mandatory for precise depiction of the vertebral abnormalities eventually detected during the initial workup. Conventional tomography is useful to detect laminar fusions and/or abnormalities of the neural arch. Examination of the genitourinary tract is mandatory (congenital kyphoscoliosis).

• Assessment of the degree of the scoliotic curve (Lip-man-Cobb method): AP plain film of the whole spine, erect position: identification of the vertebrae at either end of the scoliotic curve. The most laterally displaced and rotated vertebra, located between the two terminal vertebrae, is designated as the apical vertebra. Lines are drawn along the superior end-plate of the highest vertebra and along the inferior end-plate of the lowest vertebra (Fig. 3.61). Perpendiculars to these end-plate lines are constructed, and the angle of intersection is measured. The following four classes of increasing severity are in current use: <30° mild; 30-50° moderate; 50-70° severe; >70° very severe (Pa-paioannou et al. 1982; McAlister and Schackelford 1975)

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