Moiré topography in scoliosis. Its accuracy in detecting the site and size of the curve

Abstract

Moiré topography was added to school scoliosis screening in Singapore in 1982. The results from 1342 topographs, assessed in isolation, were used to study the accuracy of the method in predicting the radiographic location and magnitude of scoliotic curves. Accuracy in identifying the site of the curve was 68% in the thoracic spine, 54% in the thoracolumbar spine, and 15% in the lumbar region. There were 12.7% false-positive results and 4.3% false negatives. Of patients with a deviation of one moiré fringe, 76.5% had a curve of 15 degrees or less; of those with a deviation of four moiré fringes, 69% had a curve greater than 26 degrees. The prediction of the Cobb angle was less accurate when there was a deviation of two or three fringes. It is suggested that moiré topography as a screening device should be reserved for use in the second tier of screening, since the forward-bending test is an effective and cheap method for the first tier of a mass school-screening programme.