ADAM SIGN (POSITIONS)
- POSITIVE: A “c” or “s” shaped scoliosis is observed to straighten.
- POSITIVE: A “c” or “s” shaped scoliosis does not straighten.
- INDICATES: Negative: evidence of a functional scoliosis, trauma or subluxation.
- INDICATES: Positive: evidence of a pathologic or structural scoliosis.
Patient Instructions: Patient standing, with examiner standing behind patient, examiner looks for evidence of scoliosis. Examiner instructs the patient to bend forward at the waist. Examiner observes for evidence of a change in the scoliosis.
Clinical Notes: Look for rib humping, muscular imbalance, and asymmetry in hand length as findings.
Do’s and Don’ts: Do look and palpate if necessary at the spine before during and after. DO NOT let the patient bend forward if wearing a gown that is not tied up. Usually they have a male with no shirt on. DO NOT touch the patient in any way other than her spine. Explain you will be on her back looking for any deviation.
POSITIVE: Pain on the concave or convex side.
INDICATES: Pain on the concave side indicates intercostal neuritis. Pain on the convex side indicates fibrous inflammation of the pleura.
Patient Instructions: Patient seated arms fully abducted and raised over head, examiner instructs patient to laterally flex thoracic spine to the left side and then to the right side.
Clinical Notes: Possible intercostal myofasciitis as ddx from pleuritis or neuritis.
Do’s and Don’ts: Make sure the pelvis remains on the table if seated.