Rib index, an objective measure to document changes of the rib hump deformity in a risser 4 progressive ais patient treated with the Schroth method

Background The goals of Scoliosis Specific Schroth Physiotherapy (SSSPT) are to restore muscle balance, reshape the rib cage and reduce the rib hump to improve the esthetic of the patient, to increase the breathing areas and vital capacity, to reduce the Cobb angles, and to avoid spinal fusion surgery. Measuring the Cobb angles on P-A radiographs, assessing the sagittal profile on lateral radiographs, and calculating the Rib Index (RI), extracted from the Double Rib Contour Sign (DRCS) on lateral radiographs as one of the indicators of the rotational component of scoliosis, are three objective measurements Schroth physiotherapists can use to document the progression of this 3D condition. Traditionally, physicians have relied primarily on the Cobb angle when monitoring the progression and improvement of scoliosis. It is also important, however, to assess and document the rib cage rotation and rib hump size as reflected by the RI.