A postural screening for a young adult reveals a right thoracic, left lumbar scoliosis. The commonly observed postural deviation in this condition is

A postural screening for a young adult reveals a right thoracic, left lumbar scoliosis. The commonly observed postural deviation in this condition is

• A. Spinous processes of the thoracic spine rotated to the right
• B. High left shoulder
• C. Posteriorly protruding scapula to the right
• D. Prominent right posterior rib cage

Answer: (D)

In scoliosis, the spine not only curves sideways but also rotates toward the convex (outward) side of the curve. This rotation causes the ribs on that convex side to twist backward, creating a rib hump that is most visible on the posterior aspect of the rib cage. For a right thoracic curve, the convex side is the right, so the right posterior rib cage becomes prominent. This rib prominence is the classic postural finding seen on screening and is best observed when the patient flexes forward (Adams test). Note that the spinous processes actually rotate toward the concave side, so a statement claiming rotation to the right for a right thoracic curve isn’t consistent with the typical pattern. While shoulder or scapular asymmetry can occur, the most characteristic and commonly observed sign in this pattern is the prominent right posterior rib cage.

In scoliosis, the spine not only curves sideways but also rotates toward the convex (outward) side of the curve. This rotation causes the ribs on that convex side to twist backward, creating a rib hump that is most visible on the posterior aspect of the rib cage. For a right thoracic curve, the convex side is the right, so the right posterior rib cage becomes prominent. This rib prominence is the classic postural finding seen on screening and is best observed when the patient flexes forward (Adams test).

Note that the spinous processes actually rotate toward the concave side, so a statement claiming rotation to the right for a right thoracic curve isn’t consistent with the typical pattern. While shoulder or scapular asymmetry can occur, the most characteristic and commonly observed sign in this pattern is the prominent right posterior rib cage.