ScolioMedIS DB
- Data about examinations -

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Demographic characteristics
Unique identification number:
Name:
Surname:
Sex:
First menarche (girls):
Years when diagnosed scoliosis:
Other diseases/deformities: Luxatio coxae congenita:
Foot deformities:
Neurological diseases:
Respiratory diseases:
Others:
Inspection
Date of inspection:
Inspection No.:
 
 
Clinical measurements
Body height (cm):
Body weight (kg):
Spine translation (cm):  
Leg lenght (cm): Left: Right::
Lateral pelvic tilt (deg):  
Shoulder height (cm): Left: Right:
Scapular height (cm):  
Scapular remoteness (cm): Left: Right:
Stature triangle (cm): Left: Right:
Chest girth (cm): Inspirium: Expirium:
Rib hump (cm):  
Scoliometer: Scoliometer on 3 levels (deg):    
Scoliometer-predicted Cobb angle:    
Iliopsoas contracture (deg): Left: Right:
Lumbal lordosis (cm):
Fröchner index: Read values(cm): a: b: c: d:
Result (a+d)/(b+c):
Rontgen diagnostics
Date of X-ray recording:
Risser sign:
Cobb angle:
Diagnosis
Compliance
Do you attend inspections as prescribed? Do you exercise as prescribed? Average cooperation
Remarks
Inspection performed by: Date of next inspection:
 

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