Most scoliosis is idiopathic (of unknown cause) and has no associated problems other than vertebral deformity itself. In this sense the most useful to detect them in childhood is the physical examination in the consultation. Once scoliosis is suspected, an X-ray of the entire spine is usually done to see the type and degree of scoliosis. It will also serve as a reference point in monitoring the evolution of the curve during growth. In most cases with these imaging tests will be more than enough.
There are some situations that may suggest that we are dealing with a problem that is not limited to column deformity. One of the possible consequences of these variants is the involvement of the spinal cord and to see how the spinal cord we performed an MRI of the entire spine. As we have said, the normal thing is that it is not necessary to do it. We are going to comment in this post what situations make recommend the study of the column with resonance.
– The common thing in scoliosis is to detect a slight-moderate curve and that there is a possible increase of this curve during the peaks of growth. If scoliosis begins before age ten and progresses more than 10º a year in the Cobb angle we must perform an MRI of the entire spine.
– When on the radiograph we see signs that there may be lesions within the medullary canal such as an infection or a tumor is required the study with MRI.
– Scoliosis is sometimes caused by congenital changes in the formation of the vertebrae. When we detect this type of malformations we must extend the study with this test. It is important to rule out other deformities that affect the central nervous system and which may be associated. Very pronounced hyperciphosis also requires assessing marrow status in these children.
– In some cases the development of scoliosis can be accompanied by neurological symptoms such as headache, neck pain, loss of strength, pain that wakes the child at night or that limits activities. The resonance allows us to detect associated problems such as the Arnold Chiari .
– When evaluating the child with scoliosis we value the whole body during the physical examination in the consultation. There are signs that may suggest that we are not before a typical scoliosis such as: the presence of a cavus foot, loss of muscle in some region of the body, alterations in osteotendinous reflexes and lesions on the skin that suggest disease.
– The typical curves in idiopathic scoliosis occur in a given direction. We have a lumbar curve to the left and a thoracic curve to the right (always looking at the patient or the X-ray from the back, from behind). Occasionally, we will detect patients with the upside down curves, ie, right lumbar and left dorsal. As atypical curves, it is interesting to complete the study with resonance to rule out complications.
In summary, it is sometimes necessary to perform an MRI of the entire spine to complete the study of a scoliosis. In a bit annoying the test because it becomes long for a child, even sometimes it is advisable to divide it in different days. We have explained the main reasons that lead doctors to ask for this test but it is the specialist who knows us and has followed our evolution to evaluate the suitability or not to carry it out.