Journal of Pediatric Growth & Health Perspectives

Abstract

Background/Objectives: School-based musculoskeletal screening frequently identifies postural asymmetries that are often transient and related to normal growth. Distinguishing physiological developmental variability from persistent clinical findings requiring closer surveillance remains a challenge. This retrospective longitudinal observational study evaluated whether repeated assessment of predefined postural landmarks could improve the identification of children requiring further clinical follow up.

Methods: A total of 340 children aged 8–10 years participating in a school-based musculoskeletal surveillance program underwent six standardized postural assessments during one academic year. Clinical observations were repeated under different biomechanical conditions (standing, sitting, supine, prone and forward bending when indicated) to distinguish transient from persistent alterations in predefined postural landmark relationships. Children showing persistent findings were referred for further specialist evaluation according to routine clinical practice.

Results: Repeated longitudinal assessment differentiated transient postural variations from persistent clinical findings. Overall, 102 of 340 children (30.0%) demonstrated persistent postural landmark incoherence and were referred for further specialist evaluation. Radiographic examinations were performed only when clinically indicated and identified 44 structural spinal alterations requiring continued clinical follow-up in a proportion of referred children. Because imaging was not systematically performed in all participants, diagnostic accuracy, sensitivity, specificity and predictive values were not evaluated.

Conclusions: Repeated longitudinal observation of predefined postural landmark relationships may represent a useful non-invasive strategy for school-based musculoskeletal surveillance. Persistent postural landmark incoherence should not be interpreted as a diagnosis of scoliosis but as a clinical finding that

may justify closer observation and specialist assessment during growth. Prospective multicenter studies with standardized radiographic follow-up are required to confirm the clinical utility of this observational approach.