Patient characteristics at the initial visit to a scoliosis clinic: a cross-sectional study in a community without school screening.
METHODS
A cross-sectional study was conducted of all patients referred for an initial visit to the orthopedic outpatient clinic of a metropolitan pediatric hospital in Canada for suspected adolescent idiopathic scoliosis (AIS).


OBJECTIVE
To document the appropriateness of current referral patterns for AIS in comparison to those that were prevailing before discontinuation of school screening in Canada.


BACKGROUND
The consequences of the discontinuation of school scoliosis screening programs on the referral patterns of AIS patients remain unknown.


METHODS
The clinical and radiologic charts of the 636 consecutive patients referred for scoliosis evaluation over a 1-year period were reviewed. Patients were classified according to defined criteria of appropriateness of referral based on skeletal maturity and curve magnitude.


RESULTS
Of the 489 suspected cases of AIS, 206 (42%) had no significant deformity (Cobb angle <10 degrees ) and could be considered as inappropriate referrals. In subjects with confirmed AIS, 91 patients (32%) were classified as late referrals with regards to brace treatment indications.


CONCLUSIONS
These findings suggest that current referral mechanisms for AIS are leading to a suboptimal case-mix in orthopedics in terms of appropriateness of referral.
Beauséjour
Marie
M
Research Center, CHU Sainte-Justine Mother and Child University Hospital Center, Montreal, Quebec, Canada.
Roy-Beaudry
Marjolaine
M
Goulet
Lise
L
Labelle
Hubert
H
D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012572:School Health Services / Q000706:statistics & numerical data; D012600:Scoliosis / Q000175:diagnosis* / Q000453:epidemiology*