Which statement best characterizes scoliosis in an adolescent?

• A. It is more common in males and is idiopathic.
• B. There can be unequal rib prominences or shoulder heights.
• C. The diagnosis can be made when the curvature is 8 degrees or more.
• D. There is a strong familial component to this condition.

Answer: (B)

Adolescent scoliosis is best recognized by asymmetric posture of the trunk caused by a lateral curvature of the spine with some vertebral rotation. This rotation makes the rib cage on one side protrude, producing a rib hump and often uneven shoulders or shoulder heights. That rib prominence is a classic sign you’ll see on exam and is why this statement fits best.

It’s helpful to note that most cases are idiopathic and occur more often in females, with a familial tendency, but the defining clinical clue during a check is the visible trunk asymmetry and rib hump revealed by forward bending ( Adams test). Radiographs confirm the diagnosis, using the Cobb angle, with a threshold of 10 degrees or more to call it scoliosis; 8 degrees would not meet the diagnostic cut.