Ultrasound could do away with need of X-ray for scoliosis screening in children: Study

Hong Kong: Ultrasound is useful for the identification of children who do not require specialist referral for follow-up X-rays, finds a recent study in the journal Ultrasound in Medicine and Biology. This could do away with a >50% reduction of unnecessary radiation for children undergoing scoliosis screening 

Screening of scoliosis is important for timely initiation of brace treatment to lessen curve progression in skeletally immature children and adolescents. In Hong Kong, school scoliosis screening programs follow the protocol of referring children screened positive with a Moiré topography and scoliometer for confirmatory standard radiography. 

The screening program was found to have a false-positive rate despite being highly sensitive (88%) in detecting those who require specialist referral which could lead to unnecessary X-ray radiation. Radiation-free ultrasound has been reported to be reliable and valid for quantitative assessment of cure severity in scoliosis patients. Tsz-ping Lam, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, and colleagues aimed to determine the accuracy of ultrasound in determining the threshold of referral that requires X-ray for children screened positive with the scoliometer and Moiré topography in a prospective diagnostic accuracy study. 

For this purpose, the researchers recruited 442 schoolchildren with a mean Cobb angle of 14.0 ± 6.6°. 

"Our finding supports the accuracy of using ultrasound to determine referral status, which could result in a >50% reduction of unnecessary radiation for children undergoing scoliosis screening," concluded the authors. 

Reference:

The study titled, "Using Ultrasound to Screen for Scoliosis to Reduce Unnecessary Radiographic Radiation: A Prospective Diagnostic Accuracy Study on 442 Schoolchildren," is published in the journal Ultrasound in Medicine and Biology.

DOI: https://www.umbjournal.org/article/S0301-5629(21)00250-7/fulltext