Identifying scoliosis in the adolescent with thermography: a preliminary study.

Early diagnosis of adolescent idiopathic scoliosis is essential to prevent severe deformity. The accuracy of thermographic examination of the spine in the detection of minor degrees of curvature has been assessed in 125 asymptomatic young persons mean age 13.4 +/- 0.8 years who were also examined clinically and by spinal X-ray. Assessment of thermograms selected at random from the group of 154 young subjects showed that thermography has a sensitivity of 98.2% and a specificity of 91.0% in the identification of scoliosis when compared with radiography. Thermographic examination of the spine is simple, noninvasive and provides a permanent recording which is easily interpreted. It may provide an ideal method for use in large-scale prospective surveys. The criteria used to detect the thermographic abnormality associated with idiopathic scoliosis was derived from the spinal thermograms of 29 patients, mean age 10.25 +/- 4.65 years with known scoliosis, mean angle of curve 27 degrees +/- 12 degrees. In contrast to the thermal symmetry of the normal spine, all the thermograms of these patients show asymmetry, characteristically an increase in thermal emission on the concave aspect of the curve. Eight of the 16 patients with scoliosis with minor curves and a characteristic thermogram were not detected clinically. There were 25 asymmetrical thermograms in the asymptomatic group. Three of these patients had a simple postural defect, 5 had dorsal kyphosis and 16 had idiopathic scoliosis. Postural defects and kyphosis were readily recognized on clinical examination and did not produce the characteristic scoliotic thermogram.