PURPOSE: The purposes of this study were to evaluate the usefulness and limitations of chest radiographs in scoliosis screening and to compare these results with those of thoraco-lumbar standing radiographs (TLSR). MATERIALS AND METHODS: During Korean conscription, 419 males were retrospectively examined using both chest radiographs and TLSR to confirm the scoliosis and Cobb angle at the Regional Military Manpower. We compared the types of spinal curves and Cobb angles as measured from different radiographs. RESULTS: In the pattern of spinal curves, the overall matching rate of chest radiographs using TLSR was about 58.2% (244 of 419 cases). Cobb angle differences between chest radiographs and TLSR with meaningful difference was observed in 156 cases (37.2%); a relatively high proportion (9.5%) of Cobb angle differences more than 10 degrees was also observed. The matching rate of both spinal curve types and Cobb angle accuracy between chest radiographs and TLSR was 27.9% (117 among 419 cases). Chest radiographs for scoliosis screening were observed with 93.94% of sensitivity and 61.67% of specificity in thoracic curves; however, less than 40% of sensitivity (38.27%, 20.00%, and 25.80%) and more than 95% of specificity (97.34%, 99.69%, and 98.45%) were observed in thoraco-lumbar, lumbar, and double major curves, respectively. CONCLUSION: The accuracy of chest radiographs for scoliosis screening was low. The incidence of thoracic curve scoliosis was overestimated and lumbar curve scoliosis was easily missed by chest radiography. Scoliosis screening using chest radiography has limited values, nevertheless, it is useful method for detecting thoracic curve scoliosis.
Adult ; Humans ; Male ; Radiography, Thoracic/methods ; Retrospective Studies ; Scoliosis/*diagnosis/*radiography ; Young Adult

Adolescent ; Cervical Vertebrae ; physiopathology ; Female ; Humans ; Klippel-Feil Syndrome ; diagnosis ; diagnostic imaging ; physiopathology ; Neck Pain ; physiopathology ; Radiography ; Range of Motion, Articular ; Scoliosis ; congenital ; diagnosis ; diagnostic imaging ; physiopathology

Scoliosis, the abnormal lateral curvature of the spine, is an idiopathic disease often suffered by teenagers. Normally medical doctors use X-rays to measure the Cobb angle, and then assess the severity of scoliosis with it. In this paper, we point out the superiorities of image processing technique through analyzing the existing methods in the diagnosis of scoliosis. Two kinds of image processing technique are mainly introduced for scoliosis detection. The moiré stripe images show an asymmetric deformation pattern between the left-hand side and the right-hand side of human back, and these associate with Cobb angle to detect scoliosis. In order to check scoliosis through accurate three-dimensional surface features of human back, we in the second technique use different optical imaging methods to reconstruct the three-dimensional surface model of the patient's back, and extract the characteristics of the reconstructive human back to diagnose the disease. Both approaches tried to describe symmetry discrimination of human back and correlated it with the Cobb angles. Finally, we look forward to the future development in the application of image processing technique for scoliosis detection.
Adolescent ; Child ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; methods ; Male ; Mass Screening ; Moire Topography ; Optical Imaging ; methods ; Radiography ; Scoliosis ; diagnosis ; diagnostic imaging