# Scoliosis

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD70.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Screening for Adolescent Idiopathic Scoliosis: A Systematic Evidence Review for the U.S. Preventive Services Task Force - https://www.ncbi.nlm.nih.gov/books/NBK481744/
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care
- Scoliosis - disease-level clinical article (scoliosis-clinical.txt)

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
SCOLIOSIS
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD70.00 -
         condition scope only, no dose · No dose - referral pathway, no medicine given in primary
         care · Screening for Adolescent Idiopathic Scoliosis: A Systematic Evidence Review for the
         U.S. Preventive Services Task Force - https://www.ncbi.nlm.nih.gov/books/NBK481744/
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Scoliosis - disease-level clinical article (scoliosis-clinical.txt)
               (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - Most adolescents with idiopathic scoliosis do not have significant back pain from the curve
      itself
    - Many affected teens are otherwise very active, including athletes and cheerleaders
    - The adolescent idiopathic form is the commonest one in children, and it runs from age 10 to 18
  SIGNS - what you find (2)
    - Exam should note rib prominence, waistline asymmetry, and uneven shoulder height, not just the
      spinal curve  [spinal curvature]
    - Standing and forward-bending photographs help track progression and surgical outcome
  TESTS (5)
    - Formal evaluation uses standing coronal and sagittal x-rays plus left and right bending films
    - Risser classification, a marker of skeletal maturity, is worked out from the iliac crest on
      the coronal film
    - CT and MRI are not routinely needed for typical adolescent idiopathic scoliosis
    - Candidates for surgery are worked up beforehand with CBC, BMP, coagulation studies (INR/PTT),
      a urinalysis, plus a urine pregnancy test in females
    - Pulmonary function testing is also part of the work-up
  IF NOT THIS - what else fits (2)
    - Neurologic, neuromuscular, congenital, or syndromic causes of curvature must be excluded
      before calling it idiopathic
    - Idiopathic means the cause is unknown and specifically not syndromic, congenital or
      neuromuscular
  Source  StatPearls "Adolescent Idiopathic Scoliosis" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    A lateral curvature of the spine, most often idiopathic and picked up in adolescence;
            the GP's role is screening and referral to orthopedics for monitoring, bracing, or
            surgery — there is no drug treatment. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      A lateral curvature of the spine, most often idiopathic and picked up in adolescence;
            the GP's role is screening and referral to orthopedics for monitoring, bracing, or
            surgery — there is no drug treatment.
   Caution  Rapid curve progression, back pain (uncommon in idiopathic scoliosis and suggests
            another cause), associated neurological symptoms.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Must rule out non-idiopathic underlying causes such as neurologic,
            neuromuscular, congenital, or syndromic conditions.
            RED FLAG - Complications of untreated or severe scoliosis include nerve damage, lumbar
            radiculopathy, and cardiac and pulmonary restriction.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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