ADAM SIGN (POSITIONS)

1. POSITIVE: A “c” or “s” shaped scoliosis is observed to straighten.
2. POSITIVE: A “c” or “s” shaped scoliosis does not straighten.

1. INDICATES: Negative: evidence of a functional scoliosis, trauma or subluxation.
2. 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.

SCHEPELMANN SIGN

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.