This dispatch is for a particular reader. You were in a crash. Someone ordered imaging, in an emergency department or at a follow-up, and somewhere in the report, usually near the bottom, was a line you did not expect: mild scoliosis, or a word like dextroscoliosis or levoconvex curvature. Nobody had ever said that word to you before. Now it is on paper, next to the date of a crash, and you have questions.
Take a breath. This publication takes the long view, and the long view is useful here.
What the words in the report mean
Radiology reports are written for other clinicians, so they are compact. A few terms come up often.
- Scoliosis is a sideways curve of the spine. By long convention it is called scoliosis when the Cobb angle, measured on a standing film, is ten degrees or more. Degrees and decades explains the measurement.
- Dextroscoliosis or dextroconvex means the curve bows toward the right. Levoscoliosis or levoconvex means it bows toward the left.
- Mild, minimal or slight means the reader saw a small curve. Many reports written this way give no number of degrees at all.
- Incidental means the finding was noticed while looking for something else, which after a crash it almost always was.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases keeps a plain-language scoliosis page if you want a steady place to start reading.
What a single film cannot tell you
A film is a snapshot. It shows the spine as it looked on one day, in one position. Several things follow from that.
It cannot say how long the curve has been there. Most scoliosis has no known cause and is first noticed during the growth years; some develops in adulthood as discs and small joints wear unevenly over decades. Plenty of adults carry a small curve for their whole lives without anyone mentioning it, because nobody ever took a film that would show it.
It may not be taken the way curves are usually measured. Scoliosis is conventionally measured on a standing, full-spine film. Imaging after a crash is often taken lying down and covers only part of the spine, because it was ordered to answer a different question.
It can be affected by the day it was taken. Pain, muscle guarding and positioning can make a spine look more tilted on a given day. That is one more reason a single report is the start of a conversation rather than a verdict.
None of this means the finding is wrong. It means the line in the report is a question, and the answer comes from an examination and, if a clinician thinks it is warranted, from the kind of imaging designed to measure a curve.
Two questions, kept separate
People who learn about a curve this way tend to fold two different questions together. Keep them apart.
Question one: what did the crash do? This is the urgent one. Soft-tissue strain in the neck and back often shows up over days, not at the scene; the slow week walks through that timeline. This question needs an exam this week, while the injury is still distinguishable from whatever was there before.
Question two: what is this curve, and does it need follow-up? This is the long-view question, and it does not need an answer tonight. Ask the clinician who examines you whether the curve in the report changes anything about their findings or their plan, and whether they suggest any follow-up for the curve itself. If you have a primary care clinician, tell them about the report too.
A new word on a report is not a reason to delay the first question while you research the second.
What to bring and say
- A copy of the imaging report, and the images if you can get them. The facility that took them can tell you how.
- The date and a short description of the crash: the direction of the hit, whether you were braced, whether your head was turned.
- What has changed since, day by day, in plain words.
- Any history that might matter, even if it seemed unrelated: a school screening you half remember, a parent or sibling with a curve, an old back complaint.
When you call, say it was an auto injury, and say the imaging mentioned scoliosis. Getting seen covers the rest of the call.
Where to go this week
Missouri Injury Clinic, run by Joseph L. Hollingsworth, DC, takes auto-injury patients at three offices. For readers west of the rivers, the O'Fallon office at 2163 West Terra Lane is nearest: (636) 280-0990, Monday, Tuesday and Thursday 9 to 6, Wednesday and Friday by appointment. Hazelwood, (314) 627-1411, and Tesson Ferry, (314) 530-5480, are open Monday through Thursday 9 to 6 and Friday 9 to noon. Every office closes from 12 to 2.
The long view, restored
If the curve turns out to be small and quiet, it may go right back to being what it was the day before the crash: a structural fact about you that you simply did not know. Most people with a curve live full lives around it. The week after a crash is still a week for the crash.
The bright line. Chest pain, a sudden severe headache, weakness or numbness on one side, trouble speaking, a loss of bowel or bladder control, or a head injury with vomiting or worsening confusion is an emergency room trip right now, not a call to a clinic.