A doctor may suspect scoliosis if one shoulder appears to be higher than the other, or the pelvis appears to be tilted. Untrained observers often do not notice the curving in the earlier stages.

Other symptoms can include:

• Backache or low-back pain
• Fatigue
• Shoulders or hips appear uneven
• Spine curves abnormally to the side (laterally)

There may be fatigue in the spine after prolonged sitting or standing. Pain will become persistent if there is irritation to the soft tissue and wear and tear of the spine bones.

Note: Kyphoscoliosis also involves abnormal front to back curvature, with a "rounded back" appearance. See: Kyphosis

The health care provider will perform a physical exam, which includes a forward bending test that will help the doctor define the curve. The degree of curve seen on an exam may underestimate the actual curve seen on an x-ray, so any child found with a curve is likely to be referred for an x-ray. The health care provider will perform a neurologic exam to look for any changes in strength, sensation, or reflexes.

Tests may include:

• Scoliometer screening (a device measures the curvature of the spine)
• Spine x-rays (taken from the front and the side)
• MRI (if there are any neurologic changes noted on the exam or if there is something unusual in the x-ray )