Usefulness of chest radiographs for scoliosis screening: a comparison with thoraco-lumbar standing radiographs.
OBJECTIVE
The purposes of this study were to evaluate the usefulness and limitations of chest radiographs in scoliosis screening and to compare these results with those of thoraco-lumbar standing radiographs (TLSR).


METHODS
During Korean conscription, 419 males were retrospectively examined using both chest radiographs and TLSR to confirm the scoliosis and Cobb angle at the Regional Military Manpower. We compared the types of spinal curves and Cobb angles as measured from different radiographs.


RESULTS
In the pattern of spinal curves, the overall matching rate of chest radiographs using TLSR was about 58.2% (244 of 419 cases). Cobb angle differences between chest radiographs and TLSR with meaningful difference was observed in 156 cases (37.2%); a relatively high proportion (9.5%) of Cobb angle differences more than 10 degrees was also observed. The matching rate of both spinal curve types and Cobb angle accuracy between chest radiographs and TLSR was 27.9% (117 among 419 cases). Chest radiographs for scoliosis screening were observed with 93.94% of sensitivity and 61.67% of specificity in thoracic curves; however, less than 40% of sensitivity (38.27%, 20.00%, and 25.80%) and more than 95% of specificity (97.34%, 99.69%, and 98.45%) were observed in thoraco- lumbar, lumbar, and double major curves, respectively.


CONCLUSIONS
The accuracy of chest radiographs for scoliosis screening was low. The incidence of thoracic curve scoliosis was overestimated and lumbar curve scoliosis was easily missed by chest radiography. Scoliosis screening using chest radiography has limited values, nevertheless, it is useful method for detecting thoracic curve scoliosis.
Department of Neurosurgery, College of Medicine, Inha University, 27 Inhang-ro, Jung-gu, Incheon, Korea.
Chang Hyun
CH
Oh
Chan Gyu
CG
Kim
Myoung Seok
MS
Lee
Seung Hwan
SH
Yoon
Hyeong-Chun
HC
Park
Chong Oon
CO
Park
D000328:Adult; D006801:Humans; D008297:Male; D013902:Radiography, Thoracic / Q000379:methods; D012189:Retrospective Studies; D012600:Scoliosis / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D055815:Young Adult