Reliability and validity of lateral curvature assessments using clinical ultrasound for the patients with scoliosis: a systematic review



Clinical ultrasound is radiation-free, low cost and user friendly, which makes it probable in assessment of scoliosis. Numerous studies have been conducted about the feasibility of using clinical ultrasound to assess scoliosis; thus, an inclusive review of the literature would be beneficial for researchers, clinicians and patients. This study aimed to systematically review the reliability and validity of coronal curvature assessments obtained from different clinical ultrasound imaging methods.


A comprehensive search of 6 databases and Google Scholar search engine was performed for retrieving articles assessing reliability and/or validity of spinal curvature measurements obtained from clinical ultrasound. Two reviewers assessed the methodological quality of selected articles independently using criteria appraisal instrument. The results were analysed and synthesized qualitatively using level of evidence method.


Fourteen articles were included. Thirteen articles investigated both the reliability and validity, of which nine were of high quality; and one article evaluated only the reliability and was of high quality. Totally five ultrasound methods were evaluated. Very high reliability (intra-class correlation coefficient = 0.80–1.00) but limited levels of evidence were found for the majority of the studied ultrasound methods. Almost all the methods showed good to excellent validity (correlation coefficient = 0.76–1.00) but limited to moderate levels of evidence.


A high level of evidence was found in support of the reliability and validity of the COL (centre of lamina) ultrasound method. Further reliability and validity studies should be conducted to strengthen the level of evidence for those ultrasound methods with moderate, limited or conflicting level of evidence.

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Correspondence to Man-Sang Wong.

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Hui-Dong Wu, Wei Liu and Man-Sang Wong declared not having any conflict of interest.

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Wu, H., Liu, W. & Wong, M. Reliability and validity of lateral curvature assessments using clinical ultrasound for the patients with scoliosis: a systematic review. Eur Spine J 29, 717–725 (2020).

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  • Scoliosis
  • Ultrasound
  • Reliability
  • Validity