 It should be noted that the diagnosis of idiopathic scoliosis is of exclusion. This includes exclusion of a variety of neuromuscular disorders commonly associated with scoliosis, such as cerebral palsy and muscular dystrophy. Intramedullary, extramedullary, and vertebral tumors can be associated with scoliosis, with osteoid osteoma of the posterior elements perhaps being the most well-known. Vertebral infections, such as tuberculosis, may also result in kyphoscoliosis [1,2]. Conditions with dysplastic skeletal development should also be clinically excluded, including osteogenesis imperfecta, neurofibromatosis type I, Marfan syndrome, Ehlers-Danlos syndrome, and achondroplasia. Clinical presentation and physical examination in idiopathic scoliosis are negative for cutaneous stigmata that suggest underlying spinal dysraphism (hemangioma, hairy patches, nevi, dermal appendages, or sinus tracts) [10]. When radiographs reveal anomalies of vertebral formation or segmentation, the scoliosis is termed congenital, accounting for up to 10% of surgical patients [2]. Neural axis anomalies, such as hydrosyringomyelia, Chiari malformation, and cord tethering, have been reported to occur in more than 20% of such patients who thus may benefit from routine preoperative MRI [11]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org MRI MRI of the spine, with its superior soft-tissue contrast is selectively used in the setting of scoliosis to detect and characterize suspected intraspinal abnormalities.
Scoliosis Child.  It should be noted that the diagnosis of idiopathic scoliosis is of exclusion. This includes exclusion of a variety of neuromuscular disorders commonly associated with scoliosis, such as cerebral palsy and muscular dystrophy. Intramedullary, extramedullary, and vertebral tumors can be associated with scoliosis, with osteoid osteoma of the posterior elements perhaps being the most well-known. Vertebral infections, such as tuberculosis, may also result in kyphoscoliosis [1,2]. Conditions with dysplastic skeletal development should also be clinically excluded, including osteogenesis imperfecta, neurofibromatosis type I, Marfan syndrome, Ehlers-Danlos syndrome, and achondroplasia. Clinical presentation and physical examination in idiopathic scoliosis are negative for cutaneous stigmata that suggest underlying spinal dysraphism (hemangioma, hairy patches, nevi, dermal appendages, or sinus tracts) [10]. When radiographs reveal anomalies of vertebral formation or segmentation, the scoliosis is termed congenital, accounting for up to 10% of surgical patients [2]. Neural axis anomalies, such as hydrosyringomyelia, Chiari malformation, and cord tethering, have been reported to occur in more than 20% of such patients who thus may benefit from routine preoperative MRI [11]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org MRI MRI of the spine, with its superior soft-tissue contrast is selectively used in the setting of scoliosis to detect and characterize suspected intraspinal abnormalities.