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Summary
The Risser sign on posteroanterior radiographs is unreliable for assessing skeletal maturity. This study found significant discrepancies compared to anteroposterior views, impacting scoliosis management.
Area of Science:
- Orthopedics
- Radiology
- Skeletal Maturity Assessment
Background:
- The Risser sign is crucial for evaluating skeletal maturity in scoliosis.
- Interpreting the iliac apophysis on posteroanterior (PA) spine radiographs can be challenging.
- Previous studies have not evaluated the correlation between Risser sign staging on PA and anteroposterior (AP) views.
Purpose of the Study:
- To correlate Risser sign staging on posteroanterior (PA) radiographs with anteroposterior (AP) radiographs.
- To assess the accuracy of Risser sign staging on PA radiographs.
Main Methods:
- Analyzed Risser sign staging on PA radiographs in 89 girls.
- Compared PA Risser sign interpretations with AP Risser sign interpretations.
- Evaluated iliac apophysis appearance on skeletal specimens using PA views.
Main Results:
- Risser sign interpretations differed between PA and AP views in 37 out of 89 subjects (42%).
- PA views produced distorted images of the iliac apophysis.
- Medial and lateral aspects of the apophysis were superimposed over the ilium on PA views.
Conclusions:
- Risser sign staging on PA radiographs is not a reliable indicator of skeletal maturity.
- The Risser staging system was originally developed based on AP radiographs.
- Clinical interpretation of skeletal maturity should rely on AP radiographs for Risser sign assessment.