scoliosis
Enable an agent to recognise scoliosis, assess documented curve behaviour and clinical impact, and identify appropriate monitoring or specialist review using evidence matched to age, aetiology and skeletal maturity.
Research draft, second pass
A second pass drafted this model: the structure a model of this thing needs, and what is known about it in the world. The line under this one says how the second half was obtained - researched against sources, or recalled without web access, in which case nothing here was read anywhere and every claim is a lead to verify. Unreviewed either way.
recalled by Codex without web access - no source was read
Researched by: Codex
Purpose and description
Enable an agent to recognise scoliosis, assess documented curve behaviour and clinical impact, and identify appropriate monitoring or specialist review using evidence matched to age, aetiology and skeletal maturity.
Scoliosis is a three-dimensional spinal deformity involving lateral curvature and vertebral rotation, conventionally defined radiographically by a Cobb angle of at least 10 degrees on a standing frontal spinal radiograph.
It can be Check whether documented examination and imaging evidence supports the stated scoliosis diagnosis.; Match serial measurements to the same curve and flag incompatible acquisition conditions.; Summarise progression evidence alongside skeletal maturity and causal subtype.; Identify missing evidence or atypical features requiring clinician assessment.; Organise clinician-approved observation, bracing, exercise or surgical-review considerations using applicable guidance.; Link versioned terminology and population-specific evidence without replacing the clinical description..
Distinguishing features
Distinguish radiographically assessed coronal spinal curvature from isolated shoulder or waist asymmetry; screening observations alone do not establish the diagnosis.
Record the diagnostic threshold and its source: the 2016 SOSORT guidelines report an SRS criterion of Cobb angle at least 10 degrees with recognisable axial rotation. [2016 SOSORT guidelines](https://pmc.ncbi.nlm.nih.gov/articles/PMC5795289/)
Assess persistence and correction with positioning or bending to distinguish structural curvature from nonstructural deviation.
Separate lateral curvature and axial rotation from an isolated sagittal-plane kyphosis or lordosis abnormality.
Require evidence supporting the causal subtype; do not label a curve idiopathic solely because no cause has yet been recorded.
Scope
+ Structural spinal curvature and its distinction from flexible, nonstructural lateral deviation
+ Curve location, magnitude, rotation, balance and flexibility
+ Diagnostic evidence, uncertainty and versioned classification
+ Age at onset, causal subtype, skeletal maturity and progression
+ Symptoms, functional effects and condition-specific management considerations
- The patient's complete identity, health record and life history
- Care encounters, referrals, billing and service administration
- Underlying neurological, muscular or congenital disorders as independent conditions
- Brace design, imaging equipment and surgical implant specifications
- Kyphosis, lordosis, nonspecific back pain and spinal stenosis as independent conditions
- Detailed operative techniques and rehabilitation programme delivery
Characteristics
- Diagnostic assertion status
- suspected | confirmed | disputed | excluded; assessor, date and criterion source Separates an observed asymmetry or screening result from an established diagnosis.
- Cobb angle per curve
- degrees; upper and lower end vertebrae, image date, posture and brace status Supports magnitude assessment and interpretable comparison between examinations.
- Curve configuration
- curve count, region, apex, convexity and structural or compensatory designation Distinguishes multiple curves and prevents measurements from different curves being compared.
- Rotation assessment
- method-specific vertebral rotation grade or angle; trunk rotation separately in degrees Preserves the distinction between vertebral rotation and surface trunk asymmetry.
- Curve flexibility
- residual Cobb angle in degrees under a specified bending or positioning protocol Helps characterise structural persistence and treatment planning.
- Aetiological subtype
- idiopathic | congenital | neuromuscular | syndromic | degenerative | other specified | undetermined Determines which natural-history evidence and management guidance are applicable.
- Onset and recognition timing
- age in years and months at estimated onset and first recognition, with uncertainty Prevents age at diagnosis from being mistaken for age at onset.
- Skeletal maturity
- named maturity system and stage, assessment date and supporting growth observations Provides context for remaining growth and progression assessment.
- Observed curve change
- change in Cobb degrees over a stated interval, with measurement comparability and uncertainty Distinguishes supported progression from apparent change caused by measurement conditions.
- Spinal balance
- coronal and sagittal offsets in millimetres using named landmarks and posture Records alignment information that a coronal Cobb angle alone does not express.
- Clinical burden
- documented pain, activity limitation, neurological findings, respiratory effects and self-image concerns Prevents radiographic magnitude from being treated as a complete measure of impact.
- Classification mapping
- verified ICD-10, ICD-11 or SNOMED CT concept with release, jurisdiction and mapping specificity Keeps terminology assignments traceable without treating a code as diagnostic evidence.
Also called
Where this came from
wikidata · CC0 1.0
Drafted structure
Bundle to layer to finding to question, as the second pass will find it: 6 bundles · 11 layers · 19 findings · 29 questions.
Diagnostic boundary Establish what supports a scoliosis diagnosis and how its meaning is recorded.
Visible asymmetry, measured curvature and a coded diagnosis are different kinds of evidence.
Clinical and radiographic confirmation
Connect examination findings to interpretable spinal measurements.
Diagnostic evidence sufficiency
Determine whether the recorded observations satisfy the explicitly identified diagnostic criteria.
- Which issuing body, document version, Cobb threshold and rotation requirements support this diagnostic assertion? provenance
- Were the reported values obtained from radiographs, surface measurements or screening examination, and what can each establish? measurement
Condition and terminology boundaries
Separate the condition from alternative explanations and terminology assignments.
Structural boundary and code fit
Record the distinction from nonstructural deviation and preserve the specificity of classification mappings.
- What examination or positioning evidence distinguishes structural scoliosis from a flexible deviation associated with posture, pelvic obliquity or leg-length discrepancy? boundary
- Which verified ICD-10, ICD-11 or SNOMED CT concept matches the documented subtype, and what release and jurisdiction were used? provenance
Curve geometry Represent each curve and the three-dimensional alignment relevant to interpretation.
One angle cannot identify every curve or describe rotation, flexibility and overall balance.
Curve identification and magnitude
Maintain a consistent identity for each measured curve.
Reproducible curve description
Associate magnitude with location, direction and the vertebrae used to measure it.
- For each curve, what are its region, apex, convexity, end vertebrae and Cobb angle? measurement
- How are multiple curves distinguished, and what evidence supports any structural, compensatory or major-curve designation? definition
Rotation, flexibility and balance
Capture deformity features beyond the coronal angle.
Three-dimensional phenotype
Keep rotation, correction with positioning and global alignment as distinct observations.
- Which methods measured vertebral rotation, trunk rotation and coronal or sagittal balance, and what were their results? measurement
- How much curvature remains under the documented bending or positioning protocol, and were brace conditions recorded? measurement
Aetiology and growth context Determine the causal and developmental context in which this scoliosis should be interpreted.
Childhood, neuromuscular and adult degenerative presentations cannot share unqualified assumptions about course or care.
Causal subtype
Record supported causes and unresolved causal attribution.
Subtype evidence
Distinguish a supported subtype from an uninvestigated or uncertain cause.
- What history, examination or imaging supports an idiopathic, congenital, neuromuscular, syndromic or degenerative classification? provenance
- Which underlying conditions require linked models, and what causal relationship to the curvature is established versus suspected? boundary
Onset, maturity and population
Place the condition in a documented developmental and evidence context.
Developmental and population fit
Separate onset, recognition and maturity while checking whether population evidence applies.
- What are the estimated onset age, first-detection age and current skeletal maturity, including the maturity assessment method? measurement
- For any prevalence or risk estimate, what population, location, study year, curve threshold and causal subtype were studied? provenance
Course and clinical impact Assess change over time and its documented consequences.
Progression and patient burden must be established separately rather than inferred from a single image.
Longitudinal curve behaviour
Interpret serial measurements in their acquisition and growth context.
Credible progression
Determine whether observed change supports progression, stability or an indeterminate result.
- Do serial measurements describe the same curve under comparable posture, end-vertebra selection and brace conditions? measurement
- What observed change, interval and measurement uncertainty support the assigned progression state, and which criterion defines meaningful change? provenance
Symptoms, function and attribution
Record clinical effects without assuming every symptom is caused by the curve.
Burden and atypical features
Separate reported limitations, objective findings and unresolved symptom attribution.
- What pain, activity restrictions, self-image concerns, neurological findings or respiratory limitations are documented, and how were they assessed? measurement
- Which findings require prompt clinician assessment or investigation of another cause under the applicable clinical pathway? action
Management and reassessment Connect the documented condition state to justified care decisions and follow-up.
Management choices depend on more than curve magnitude and require explicit goals and reassessment criteria.
Management option fit
Assess the applicability of proposed observation or treatment pathways.
Individualised management rationale
Record why a clinician proposes observation, scoliosis-specific exercise, bracing or surgical review for this presentation.
- Which guideline and version supports the proposed option for this subtype, curve pattern, growth stage, progression and clinical burden? provenance
- What goals, preferences, contraindications and uncertainties must the clinician and patient address before choosing that option? action
Follow-up and treatment response
Define how the condition will be reassessed during observation or treatment.
Response and escalation evidence
Track outcomes with enough treatment context to interpret apparent improvement or deterioration.
- What follow-up interval, imaging justification and clinical changes trigger reassessment or specialist escalation? action
- How will curve change, growth, function, treatment exposure, brace wear when applicable and adverse effects be recorded to judge response? measurement
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Check these first
Recalled without web access and unsourced; every item is a lead to verify.
- This is recalled knowledge, not source-verified research; current guideline editions and exact terminology should be checked.
- Functional scoliosis is included in some classifications, but its relationship to a strict definition requiring structural rotation needs explicit treatment.
- No prevalence estimate is supplied because estimates depend on population, age, study year and diagnostic threshold.
- Which of these check these first hold for the sense of scoliosis this model covers, and on what evidence? provenance
Kinds and varieties
Recalled without web access and unsourced; every item is a lead to verify.
- Idiopathic scoliosis, classified by age at onset
- Congenital scoliosis associated with vertebral malformations
- Neuromuscular scoliosis
- Syndromic scoliosis
- Adult degenerative scoliosis
- Functional or nonstructural scoliosis
- Which of these kinds and varieties hold for the sense of scoliosis this model covers, and on what evidence? provenance
Identifiers and schemes
Recalled without web access and unsourced; every item is a lead to verify.
- ICD-10 - M41 - WHO category for scoliosis; congenital forms may be classified elsewhere, and national modifications add coding detail.
- SNOMED CT - Numeric concept identifiers - Contains scoliosis and subtype concepts; exact identifiers and edition require verification.
- Which of these identifiers and schemes hold for the sense of scoliosis this model covers, and on what evidence? provenance
Standards and regulation
Recalled without web access and unsourced; every item is a lead to verify.
- Scoliosis Research Society (SRS): terminology and radiographic conventions for describing scoliosis.
- Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT): guidelines for conservative treatment of idiopathic scoliosis during growth.
- Which of these standards and regulation hold for the sense of scoliosis this model covers, and on what evidence? provenance
Real-world use
Recalled without web access and unsourced; every item is a lead to verify.
- Clinical assessment distinguishes structural deformity from flexible curvature and investigates underlying causes.
- Serial assessment during growth tracks curve progression and informs observation, bracing or specialist referral.
- Curve pattern, skeletal maturity and progression help guide treatment planning.
- Adult assessment evaluates pain, neurological symptoms, spinal balance and functional limitation.
- The condition is recorded separately from the diagnostic assessment, treatment encounter and individual patient.
- Which of these real-world use hold for the sense of scoliosis this model covers, and on what evidence? provenance
Typical measurements
Recalled without web access and unsourced; every item is a lead to verify.
- Cobb angle - At least 10 degrees is the conventional radiographic threshold; severity varies widely. - degree
- Angle of trunk rotation - Approximately 5-7 degrees is used as a referral threshold in some screening protocols; it does not establish the diagnosis. - degree
- Which of these typical measurements hold for the sense of scoliosis this model covers, and on what evidence? provenance
Failure modes and hazards
Recalled without web access and unsourced; every item is a lead to verify.
- Progressive structural curvature can produce increasing deformity and impaired spinal balance, particularly during remaining growth.
- Severe thoracic deformity can restrict respiratory function.
- Adult degenerative disease may coexist with spinal stenosis, nerve compression and functional disability.
- Pain or neurological abnormalities attributed automatically to scoliosis can delay recognition of another disorder.
- Radiographic positioning, end-vertebra selection and measurement variability can create apparent progression.
- Which of these failure modes and hazards hold for the sense of scoliosis this model covers, and on what evidence? provenance
Regional variation
Recalled without web access and unsourced; every item is a lead to verify.
- School screening policies and referral thresholds differ between health systems.
- ICD-10 national modifications differ in coding detail; code selection requires the jurisdiction and revision.
- Access to specialist assessment, custom bracing and surgery varies between regions.
- Which of these regional variation hold for the sense of scoliosis this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Recalled without web access and unsourced; every item is a lead to verify.
- Spinal asymmetry - A lateral curve below 10 degrees falls below the conventional radiographic threshold for scoliosis.
- Kyphosis - Kyphosis describes sagittal-plane posterior convexity; scoliosis involves lateral curvature and rotation, although both can coexist.
- Functional spinal curvature - A flexible curve caused by factors such as pelvic obliquity may resolve when the cause or position changes; structural scoliosis retains a fixed component.
- Kyphoscoliosis - Specifically denotes combined scoliosis and excessive kyphosis.
- Which of these neighbouring kinds and how to tell them apart hold for the sense of scoliosis this model covers, and on what evidence? provenance
What the second pass must settle
- Which diagnostic authority and version should govern threshold-edge cases, including differing wording around exactly 10 degrees and requirements for rotation?
- Which ICD-10 jurisdictional variants, ICD-11 entities and SNOMED CT releases provide verified mappings across the included scoliosis subtypes?
- Which measurement protocols and uncertainty limits should govern progression judgments across ages, imaging systems and brace conditions?
- Which current guidance applies separately to early-onset, adolescent idiopathic, congenital, neuromuscular and adult degenerative scoliosis?
- Which population- and year-specific prevalence estimates and validated outcome measures adequately represent each subtype without extrapolating adolescent evidence to all scoliosis?