A 10-year-old child has been referred for evaluation of scoliosis, which was identified in a school screening program. On physical examination the PNP finds a curvature of the spine when it is anteriorly flexed from the trunk. There is slight shoulder asymmetry, with prominence of the scapula. The curvature is at 10 degrees. The PNP should:

A 10-year-old child has been referred for evaluation of scoliosis, which was identified in a school screening program. On physical examination the PNP finds a curvature of the spine when it is anteriorly flexed from the trunk. There is slight shoulder asymmetry, with prominence of the scapula. The curvature is at 10 degrees. The PNP should:

• A. Refer the child to an orthopedist for further evaluation
• B. Inform the parents that the child is going through a growth spurt and schedule an appointment for further evaluation in 1 year
• C. Consult with the clinic physician
• D. Order x-ray films of the spine

Answer: (C)

When scoliosis is identified in a child who is still growing, the next step is to coordinate a plan with the supervising physician. The finding described is mild (a small curvature with some shoulder asymmetry). In such cases, immediate imaging or specialist referral isn’t automatically required; management depends on the clinician’s assessment of progression risk and the plan for follow-up. Consulting with the clinic physician allows the team to decide whether to obtain radiographs to quantify the curve, set a surveillance schedule, or refer if progression is likely or if the curve exceeds thresholds for bracing or orthopedic intervention. This collaborative approach ensures appropriate use of imaging and timely follow-up, tailored to the child’s growth and risk of progression.

When scoliosis is identified in a child who is still growing, the next step is to coordinate a plan with the supervising physician. The finding described is mild (a small curvature with some shoulder asymmetry). In such cases, immediate imaging or specialist referral isn’t automatically required; management depends on the clinician’s assessment of progression risk and the plan for follow-up. Consulting with the clinic physician allows the team to decide whether to obtain radiographs to quantify the curve, set a surveillance schedule, or refer if progression is likely or if the curve exceeds thresholds for bracing or orthopedic intervention. This collaborative approach ensures appropriate use of imaging and timely follow-up, tailored to the child’s growth and risk of progression.