Screen for scoliosis with the Adams test and a scoliometer
Enter the angle of trunk rotation (ATR) you measured with a scoliometer in the forward bend test; see the maximum angle and the screening result.
How to measure
- 1The child stands upright, barefoot, with feet together and knees straight; the back is uncovered.
- 2Arms hanging and palms together, they slowly bend forward until the back is horizontal.
- 3Standing behind, place the scoliometer across the back with the notch over the spine, at the most prominent point of each region, without pressing.
- 4Read the angle separately for the upper back, the transition zone and the lower back.
- 5Repeat the measurement once more and enter the higher value for each region.
Angle of trunk rotation (ATR)
Enter at least one region. Leave any region you did not measure blank.
0–30°, in 0.5° steps
0–30°, in 0.5° steps
0–30°, in 0.5° steps
Screening result
Enter the ATR for at least one region.
A screening method, not a diagnosis
This tool does not make a diagnosis. Scoliosis is diagnosed by measuring the Cobb angle on a standing spinal radiograph; treatment and follow-up decisions belong to the physician.
Have an X-ray? Cobb angle calculator →
Sources
- Bunnell WP. An objective criterion for scoliosis screening. J Bone Joint Surg Am. 1984;66(9):1381–1387. doi:10.2106/00004623-198466090-00010
- Bunnell WP. Outcome of spinal screening. Spine. 1993;18(12):1572–1580. doi:10.1097/00007632-199309000-00001
- Amendt LE et al. Validity and reliability testing of the Scoliometer. Phys Ther. 1990;70(2):108–117. doi:10.1093/ptj/70.2.108
Who are you?
Run this measurement automatically from a scan in your clinic
In a 30-minute demo we'll show the same calculation on a 3D scan, with your own case. Your result is added to the form automatically.
Result added to the form
No calculated result yet — you can still send the form.
Frequently asked questions
What is the Adams forward bend test?
The Adams forward bend test is a simple examination used to screen for scoliosis. Standing barefoot with feet together and knees straight, the person lets the arms hang with palms together and bends forward until the back is horizontal. Viewed from behind, a clear prominence on one side of the back (a rib or lumbar hump) can indicate rotation of the spine.
What is the angle of trunk rotation (ATR) and how is it measured with a scoliometer?
The angle of trunk rotation (ATR) is the tilt between the two sides of the back in the Adams position. A scoliometer is an inclinometer with a notch in the middle: it is placed across the back with the notch over the spine, at the most prominent point of each region, without pressing, and the angle is read. Measure the upper back (thoracic), the transition zone (thoracolumbar) and the lower back (lumbar) separately. Phone inclinometer apps can also be used, but their accuracy varies with the device and placement; have the result confirmed by a clinician.
Which ATR values warrant referral to a doctor?
Bunnell (J Bone Joint Surg Am 1984) proposed 5° as the minimum significant ATR; this threshold detects curves of 20° or more with few misses but generates many unnecessary referrals. In Bunnell's 1993 outcome study (Spine 1993), an ATR of 7° at any level was reported as an appropriate referral criterion. For values between 5° and 7°, re-measurement or follow-up can be planned with a clinician.
Does a normal screen rule out scoliosis? What is the next step?
No. A screening test does not make a diagnosis; the correlation between ATR and the Cobb angle is moderate (Amendt et al., Phys Ther 1990). Scoliosis is diagnosed by measuring the Cobb angle on a standing spinal radiograph. If there are symptoms, a family history or changes during growth, the measurement should be repeated periodically and a physician's assessment requested.