Putting Prevention into Practice
An Evidence-Based Approach
Screening for Adolescent Idiopathic Scoliosis
Am Fam Physician. 2018 May 15;97(10):666-667.
Author disclosure: No relevant financial affiliations.
A 10-year-old girl with no significant medical history presents to your clinic for a school physical and well visit. She will begin fifth grade in the fall and actively participated in a summer soccer program at a local sports club. She reports no associated injuries or pain; however, her mother expresses concern that she wore a heavy backpack with her sports equipment every day during the summer and asks about screening for scoliosis.
Case Study Questions
1. Which one of the following statements accurately summarizes the U.S. Preventive Services Task Force (USPSTF) findings about screening for idiopathic scoliosis in healthy, asymptomatic children and adolescents?
A. The USPSTF has high certainty that the net benefit of screening is substantial.
B. The USPSTF has high certainty that the net benefit of screening is moderate.
C. The USPSTF has at least moderate certainty that the net benefit of selectively screening patients is small.
D. The USPSTF recommends against screening because it has moderate to high certainty that screening has no net benefit or that the harms outweigh the benefits.
E. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening.
2. Which one of the following statements about screening for and treatment of idiopathic scoliosis in children and adolescents is correct?
A. Exercise is not recommended for children and adolescents with a Cobb angle measuring 10° or greater who are being monitored conservatively.
B. The USPSTF found adequate evidence that treatment with exercise has benefit among adolescents with a Cobb angle measuring less than 50° at diagnosis.
C. The USPSTF found adequate evidence that treatment with bracing may decrease curvature progression among adolescents with mild or moderate curvature severity.
D. An angle of trunk rotation of 10° on the scoliometer is the threshold for referral for radiography.
E. Children and adolescents with scoliosis typically present with back
1. US Preventive Services Task Force. Screening for adolescent idiopathic scoliosis: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(2):165–172.
2. Dunn J, Henrikson NB, Morrison CC, Blasi PR, Nguyen M, Lin JS. Screening for adolescent idiopathic scoliosis: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;319(2):173–187.
This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and the supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/adolescent-idiopathic-scoliosis-screening1.
This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.
A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.
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