Scoliosis

Introduction

Scoliosis is a sideways curvature of the spine usually, but not always, becoming evident during adolescence. 

Symptoms may include uneven shoulders, one shoulder blade appearing more prominent, uneven hips or waist.

Pre-referral investigations

• Physical examination - look for any shoulder, trunk, rib or waist asymmetry. Observe for any leg length discrepancy.
• PA and lateral x-ray of complete spine – standing
• Cobb angle to be reported 
• Relevant family history

Pre-referral management

Cobb angles of less than 10 are considered to be normal variants and require no treatment.  

When to refer

Refer to Orthopaedics:

• Under 13 years of age OR all pre-menarchal female patients with a cobb angle greater than 10 degrees 
• 13 to 16 years of age with a cobb angle greater than 20 degrees
• Over 16 years of age – refer to Royal Perth Hospital
• Any scoliotic curve in children with underlying conditions that predispose to scoliosis such as neuromuscular conditions and chromosomal/genetic abnormalities.

How to refer

• Routine non-urgent referrals from a GP or a Consultant are made via the Central Referral Service
• Routine non-urgent referrals from private hospitals are made via the PCH Referral Office
• Urgent referrals (less than seven days) are made via the PCH Referral Office. Please call PCH Switch on 6456 2222 to discuss referral with the Orthopaedic registrar.  

Essential information to include in your referral

• Patient demographics 
• X-ray report and contact details of radiology service
• Cobb angle must be reported 
• Female patients - Menarchal status/date of menarche if post menarchal.

Reviewer/Team:	Dr Kate Stannage, Orthopaedics Dept, PCH	Last reviewed:	Sep 2021
		Review date:	Sep 2024
Endorsed by:	Fast track approval	Date:	Sep 2021

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