Scoliosis is a curving of the spine. The spine curves away from the middle or sideways.

There are three general causes of scoliosis:

• Congenital scoliosis is due to a problem with the formation of vertebrae or fused ribs during prenatal development.
• Neuromuscular scoliosis is caused by problems such as poor muscle control or muscular weakness or paralysis due to diseases such as cerebral palsy, muscular dystrophy, spina bifida, and polio.
• Idiopathic scoliosis is of unknown cause, and appears in a previously straight spine.

Idiopathic scoliosis in adolescents is the most common type. Some people may be prone to the curving of the spine. Most cases occur in girls. Curves generally worsen during growth spurts. Scoliosis in infants and juveniles are less common. They commonly affect a similar number of boys and girls.

Scoliosis may be suspected when one shoulder appears to be higher than the other, or the pelvis appears to be tilted. Untrained observers usually can't notice the curving.

Routine scoliosis screening is now done in middle and junior high schools. Many cases, which  previously would have gone undetected until they were more advanced, are now being caught at an early stage.

There may be fatigue in the spine after prolonged sitting or standing. Pain will become persistent if irritation results. The greater the initial curve of the spine, the greater the chance the scoliosis will get worse after growth is complete. Severe scoliosis (curves in the spine greater than 100 degrees) may cause breathing problems.

• The spine curves abnormally to the side (laterally)
• Shoulders or hips appearing uneven
• Backache or low-back pain
• Fatigue

Note: Kyphoscoliosis also involves abnormal front-to-back curvature, with a "rounded back" appearance. See kyphosis.

The health care provider will perform a physical exam, which includes a forward bending test that will help the doctor define the curve. The degree of curve seen on an exam may underestimate the actual curve seen on an x-ray, so any child found with a curve is likely to be referred for an x-ray. The health care provider will perform a neurologic exam to look for any changes in strength, sensation, or reflexes.

Tests may include:

• Spine x-rays (taken from the front and the side)
• Scoliometer measurements (a device for measuring the curvature of the spine)
• MRI (if there are any neurologic changes noted on the exam or if there is something unusual in the x-ray )