What Does Your Doctor Do About It?
Your doctor will take a detailed history and perform a careful examination to determine the severity of the curvature, as well as to rule out any underlying cause for the scoliosis, before labelling it "idiopathic". He will have your child bend forward away from him, and check for any asymmetry as described above. He will use an instrument called a Scoliometer to measure the angle of trunk rotation (ATR). An ATR of 7 degrees or more requires an X-ray.
He will order a standing X-ray of your child's spine, to check the alignment of the spine, and measure the extent and angle of the curvature. The severity of the scoliosis is expressed as angle of curvature, using a measuring technique on the X-ray film, known as the Cobb method.
From the X-rays, your doctor will be able to assess the maturity of the spine, and if there is still any more growth left to the spine. This has great significance for prognosis, since the scoliosis can get worse with growth. If the curve is severe enough, he may also do side-bending X-rays to assess the rigidity of the curve. Occasionally, he may order an MRI if he suspects any underlying problem in the spinal cord.
The decision to treat depends on several factors. Firstly, you need to realize that once a child has scoliosis, she will continue to have it. The scoliosis does not revert to "normal". Secondly, most curves are mild (less than 20 degrees) and stay mild.
These do not cause any medical or cosmetic problems, and are best left alone. If your doctor discovers you have a scoliosis of less than 20 degrees, he will probably not recommend any treatment, other than regular checkups and observation. If your child is prepubertal, the doctor may see her just once a year, and perform annual X-rays as necessary to check on the curve.
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