School scoliosis screening in Hong Kong : trunk asymmetry of girls with scoliosis

Abstract

Background: The school scoliosis screening aims to identify students with spinal deviations by trunk asymmetry. The objective of this study is to investigate the accuracy of scoliosis screening with a low ATR cut-off and occurrence of shoulder obliquity. Methods: 443 schoolgirls aged between 10-13 years participated in this school scoliosis screening. During the screening, a forward bending test with ATR measurement using scoliometer were adopted to detect the trunk asymmetry and the backside photographs were captured for shoulder obliquity measurement. The ATR cut-off point was 3°. Participants with ATR ≥3° were invited to conduct an ultrasound spinal examination for Cobb’s angle measurement. The positive predictive value of ATR≥3° was calculated. Findings: It is found that 17.8% of the screened students possibly have early scoliosis. The positive predictive value of ATR ≥3° was 0.717. There is a significant negative correlation between the BMI range and occurrence of ATR ≥3°. 55.7% of girls with ATR≥3° had shoulder obliquity. There is a significant positive correlation between the occurrence of shoulder obliquity and ATR ≥3°.