Adolescent idiopathic scoliosis screening: Could a school-based assessment protocol be useful for an early diagnosis?

BACKGROUND: Adolescent idiopathic scoliosis screening still needs a considerable implementation, particularly throughout a school-based assessment protocol. OBJECTIVE: This study aims to evaluate the effectiveness of clinical examinations currently in use for the diagnosis of adolescent idiopathic scoliosis, through a survey carried out in secondary schools to standardize a screening protocol that could be generalized. METHODS: In their classrooms, the adolescents underwent an idiopathic scoliosis screening through three examinations: Adam’s test, axial trunk rotation (ATR) and plumb line. In case of single positivity to one of the three examinations, a column X-ray examination was recommended. RESULTS: The sensitivity and diagnostic specificity of Adam’s test or ATR were 56.3% and 92.7%, respectively. The positivity to at least one between ATR or plumb line showed that sensitivity was higher than specificity: 91.3% versus 80.8%; the positivity to at least one between Adams’s test or plumb line showed a sensitivity of 95.2% and a specificity of 81.5%. Finally, the positivity to all three examinations showed an increase in specificity (99.7%). CONCLUSIONS: Taken together, our findings show that this school-based screening protocol had a very high specificity in early diagnosis of adolescent idiopathic scoliosis.

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Referral patterns and patient characteristics at the first visit to a scoliosis center: a 2-year experience in South Korea without a school scoliosis-screening program

Journal of Neurosurgery Pediatrics ◽

10.3171/2017.10.peds17348 ◽

2018 ◽

Vol 21 (4) ◽

pp. 414-420

Author(s):

Nam Ik Cho ◽

Chang Ju Hwang ◽

Ho Yeon Kim ◽

Jong-Min Baik ◽

Youn Suk Joo ◽

...

Keyword(s):

Health Care ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

South Korea ◽

Screening Program ◽

Referral Rate ◽

Referral Patterns ◽

School Screening ◽

Late Referral ◽

Scoliosis Screening

OBJECTIVEThe need for scoliosis screening remains controversial. Nationwide school screening for scoliosis has not been performed in South Korea, and there are few studies on the referral patterns of patients suspected of having scoliosis. This study aimed to examine the referral patterns to the largest scoliosis center in South Korea in the absence of a school screening program and to analyze the factors that influence the appropriateness of referral.METHODSThe medical records of patients who visited a single scoliosis center for a spinal deformity evaluation were reviewed. Among 1895 new patients who visited this scoliosis center between April 2014 and March 2016, 1211 with presumed adolescent idiopathic scoliosis were included in the study. Patients were classified into 4 groups according to the referral method: non–health care provider, primary physician, hospital specialist, or school screening program. The appropriateness of referral was labeled as inappropriate, late, or appropriate. In total, 213 of 1211 patients were excluded because they had received treatment at another medical facility; 998 patients were evaluated to determine the appropriateness of referral.RESULTSOf the 998 referrals of new patients with presumed adolescent idiopathic scoliosis, 162 (16.2%) were classified as an inappropriate referral, 272 (27.3%) were classified as a late referral, and 564 (56.5%) were classified as an appropriate referral. Age, sex, Cobb angle of the major curve, and skeletal maturity were identified as statistically significant factors that correlated with the appropriateness of referral. The referral method did not correlate with the appropriateness of referral.CONCLUSIONSUnder the current health care system in South Korea, a substantial number of patients with presumed adolescent idiopathic scoliosis are referred either late or inappropriately to a tertiary medical center. Although patients referred by school screening programs had a significantly lower late referral rate and higher appropriate referral rate than the other 3 groups, the referral method was not a significant factor in terms of the appropriateness of referral.

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Development and validation of deep learning algorithms for scoliosis screening using back images

Communications Biology ◽

10.1038/s42003-019-0635-8 ◽

2019 ◽

Vol 2 (1) ◽

Cited By ~ 5

Author(s):

Junlin Yang ◽

Kai Zhang ◽

Hengwei Fan ◽

Zifang Huang ◽

Yifan Xiang ◽

...

Keyword(s):

Deep Learning ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Radiation Exposure ◽

Learning Algorithms ◽

Predictive Values ◽

Spinal Disorder ◽

Severity Grading ◽

Development And Validation ◽

Scoliosis Screening

Abstract Adolescent idiopathic scoliosis is the most common spinal disorder in adolescents with a prevalence of 0.5–5.2% worldwide. The traditional methods for scoliosis screening are easily accessible but require unnecessary referrals and radiography exposure due to their low positive predictive values. The application of deep learning algorithms has the potential to reduce unnecessary referrals and costs in scoliosis screening. Here, we developed and validated deep learning algorithms for automated scoliosis screening using unclothed back images. The accuracies of the algorithms were superior to those of human specialists in detecting scoliosis, detecting cases with a curve ≥20°, and severity grading for both binary classifications and the four-class classification. Our approach can be potentially applied in routine scoliosis screening and periodic follow-ups of pretreatment cases without radiation exposure.

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Role of Sediment Cytology in the Early Diagnosis of Bone Lesions and Its Comparison with Histopathological Findings

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/31 ◽

2021 ◽

Vol 8 (03) ◽

pp. 162-167

Author(s):

Aiswarya K.P. ◽

Priya V.S ◽

Deepthi Raj M.L ◽

Indira K

Keyword(s):

Early Diagnosis ◽

High Specificity ◽

Final Diagnosis ◽

Bone Lesions ◽

Diagnostic Efficacy ◽

Moderate Sensitivity ◽

Malignant Lesions ◽

Very High ◽

Rapid Tool

BACKGROUND Though histopathology is the gold standard investigation for diagnosing most benign and malignant lesions of bone, the decalcification process required for removing bone hardness makes it a time-consuming process. Sediment cytology is a rapid investigative procedure utilising the cells in the specimen containers after proper fixation, processing and staining. The objective of this study was to compare the diagnostic efficacy of sediment cytology of bone lesions with the histopathology. METHODS The study was conducted in 50 samples of bony tissues received in the histopathology lab during the study time. The fixative fluid containing specimens were first agitated for procuring the cells from the sample. The sediment obtained was processed and stained as a cytology sample and studied under microscope. Based on cytology findings they were classified into benign, malignant, inflammatory and inconclusive. The specimen was processed as routine histopathologic sample and final diagnosis was made from it. RESULTS Sediment cytology of malignant bone lesions showed a very high specificity (100 %) but only a moderate sensitivity of 80 %. Sediment cytology of benign bone lesions also showed a higher specificity of 100 % but only a moderate sensitivity of 84.6 %. CONCLUSIONS If adequately cellular, biopsy sediment cytology is a simple, inexpensive, rapid tool for the early diagnosis of bone lesions. Sediment cytology can act as a good complementary test to histopathology. KEYWORDS Bone Lesions, Cytology, Sediment Cytology, Histopathology

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The smartphone scoliosis screening software for measuring the Cobb angle of adolescent idiopathic scoliosis: A reliability study

Intelligent Surgery ◽

10.1016/j.isurg.2022.01.001 ◽

2022 ◽

Author(s):

Song Yuepeng ◽

Shi Xinge ◽

Gao Yanzheng ◽

Hu Weiran ◽

Ma Haohao ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Reliability Study ◽

Scoliosis Screening ◽

Screening Software

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Adolescent Idiopathic Scoliosis Screening of Schoolgirls

Annals of Saudi Medicine ◽

10.5144/0256-4947.1992.555 ◽

1992 ◽

Vol 12 (6) ◽

pp. 555-557 ◽

Cited By ~ 2

Author(s):

Abdullah Abo-Bakr ◽

Abdullah Al-Mazyiad ◽

Muneera Al-Hussein ◽

Reem Al-Sudairy ◽

Mamoun Krimli ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Scoliosis Screening

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Idiopathic scoliosis and associated factors among school children: a school-based screening in Ethiopia

Archives of Public Health ◽

10.1186/s13690-021-00633-0 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Moges Gashaw ◽

Balamurugan Janakiraman ◽

Gashaw Jember Belay

Keyword(s):

Idiopathic Scoliosis ◽

School Children ◽

Primary Schools ◽

Associated Factors ◽

Bend Test ◽

Bending Test ◽

Binary Logistic Regression Model ◽

Cross Sectional Survey ◽

School Based ◽

Scoliosis Screening

Abstract Background Early detection of scoliosis is a preface to prevent progression. In resource-constrained countries like Ethiopia, there is a need for a cost-effective reliable solution for screening. The surprising fact is that there is neither idiopathic scoliosis screening nor reporting of data from Ethiopia. This study aimed to identify the magnitude, associated factors of scoliosis among school children by using non-invasive and less expensive scoliometer Smartphone app and Adams forward bending test. Methods A school-based cross-sectional survey was carried out from March to June 2019 at seven primary schools. Children were screened by using physical examination (Adams forward bend test) and scoligauge iPhone app. Univariate and multivariable binary logistic regression model analysis was used to identify factors associated with idiopathic scoliosis. Results A total of 1905 children aged between 5 and 16 years were screened, 3.3 % (95 % CI 2.5–4.1) of them were found positive using the scoligauge HD and among them only 1.8 % were identified positive for Adam’s forward bend test. The associated factors of idiopathic scoliosis identified by multivariate analysis were; spinal pain (AOR 4.1, 95 % CI 2.42, 6.89), student sitting on stool: (AOR, 7.03; 95 % CI, 1.52, 32.5), sitting on the bench with a backrest (AOR 4.12; 95 %CI, 1.12, 15.14) and sitting on the bench without backrest: (AOR 4.56; 95 % CI 1.20, 17.34). Conclusions The magnitude of idiopathic scoliosis was relatively low in study setup. More attention is needed towards sitting furniture designs and for children reporting spinal pain.There is a reasonable level of recommendation to advocate that large school-based scoliosis screening was able to detect scoliosis among school children.

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Novel Hump Measurement System With a 3D Camera for Early Diagnosis of Patients With Adolescent Idiopathic Scoliosis: A Study of Accuracy and Reliability

Cureus ◽

10.7759/cureus.8229 ◽

2020 ◽

Author(s):

Tatsuya Sato ◽

Ikuho Yonezawa ◽

Toshinari Akimoto ◽

Terada Nobuyuki ◽

Yukitoshi Shimamura ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Early Diagnosis ◽

Idiopathic Scoliosis ◽

Measurement System ◽

3D Camera

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Assessment of Early Juvenil Idiopathic Scoliosis: Clinical Trial for the Evaluation of A School-Based Screening Protocol

10.21203/rs.3.rs-38841/v1 ◽

2020 ◽

Author(s):

Dalila Scaturro ◽

Pietro Terrana ◽

Caludio Costantino ◽

Lorenza Lauricella ◽

Sofia tomasello ◽

...

Keyword(s):

Screening Program ◽

Health Care Expenditure ◽

Plumb Line ◽

Screening Tests ◽

X Rays ◽

School Based ◽

Screening Protocol ◽

Line Test ◽

Medical Examinations ◽

Clear Increase

Abstract This study aims to evaluate the effectiveness of clinical tests currently in use for the diagnosis of JIS, through a survey, carried out in secondary schools in the province of Palermo, in order to standardize a school screening protocol that could be extended to the whole regional territory. The adolescents underwent a specialist physiatric examination in their classrooms; moreover three screening tests have been administred: Adams test, Bunnel Inclinometer and Plumb line test. In case of single positivity to one of the three tests, the adolescent underwent to radiography of the whole column. Then we examined the sensitivity and diagnostic specificity of the Adams or inclinometer test, respectively: 56.3% and 92.7%. On the other hand, the positivity to at least one between inclinometer or plumb line sensitivity was higher than the specificity: 91.3% versus 80.8%. The same happened for the positivity to at least one test between Adams index or plumb line test, which showed a sensitivity of 95.2% compared to a specificity of 81.5%. Finally, taking into consideration patients with triple test positivity, a clear increase in specificity compared to sensitivity was demonstrated, reaching 99.7% Performing a single test cannot be considered a sufficient tool aiming to detect potential scoliotic subjects. To conclude, an effective screening program can reduce health care expenditure related to specialist medical examinations as well as unnecessary instrumental exams such as X-rays.

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