ORAL PRESENTATION Open Access Validity of a quantitative tool of trunk asymmetry based on digital photographs in patients with idiopathic scoliosis Antonia Matamalas*, Joan Bago, Elisabetta DAgata, Ferran Pellise From 11th International Conference on Conservative Management of Spinal Deformities - SOSORT 2014 Annual Meeting Wiesbaden, Germany. 8-10 May 2014 Background Some measures of trunk deformity obtained in digital photography may be useful in the assessment of trunk deformity. The relationships between these measures and radiographic indexes have not been fully analyzed. Aim To assess the reliability and validity of a clinical assess- ment tool of the trunk deformity based on photographs as compared to radiological measurements. Study design Cross-sectional study. Concurrent validity between pos- tural indexes obtained from digital photographs and radiographs. Methods Front and back digital photographs of patients with idio- pathic scoliosis (Cobb>25º) were obtained. Shoulder, armpit and waist angles, in addition to trunk asymmetry indexes, were calculated on front and back photographs with Surgimap software. On AP radiographs Coronal Cobb angles and radiological shoulder imbalance using CRIA angle (Angle between horizontal line and a line drawn between, the right and left intersection points of clavicle and rib cage) were calculated. Intra-class corre- lation coefficient was used to assess intra and inter-rater reliability. The Pearson correlation coefficients (r) were used to estimate concurrent validity between both methods. Results 80 patients (68 females) mean age 20.3 years (12-40 years) were included. Mean Cobb Maximum (CobbMax) was 45.9º (25.1º-77.2º).All measures had a good to excel- lent intra and inter-rater reliability both in front and back photographs. Waist height angle and CobbMax angle, both in front and back photographs, were signifi- cantly correlated (r=0.42 back/r=0.29 front view). There was no significant correlation between proximal thoracic curve magnitude and any of the shoulder measures. The correlation between shoulder and armpit height angles and radiographic clavicle tilt were -0.44 and -0.41 respectively on frontal view. There was a correlation between trapezium angle ratio and clavicle tilt in both views (r=0.43 back/r=0.32 front view). No other statisti- cally significant correlations between both methods were found. Conclusions Digital photography measurement of waist height is use- ful to assess trunk deformity in idiopathic scoliosis due to a good correlation with Cobb. Shoulder asymmetry indexes like shoulder height angle can be clinical mea- sures of shoulder imbalance. Trunk asymmetry indexes are not correlated with radiological measures. Published: 4 December 2014 doi:10.1186/1748-7161-9-S1-O6 Cite this article as: Matamalas et al.: Validity of a quantitative tool of trunk asymmetry based on digital photographs in patients with idiopathic scoliosis. Scoliosis 2014 9(Suppl 1):O6. Hospital Vall Hebron, Barcelona, Spain Matamalas et al. Scoliosis 2014, 9(Suppl 1):O6 http://www.scoliosisjournal.com/supplements/9/S1/O6 © 2014 Matamalas et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. http://creativecommons.org/licenses/by/4.0 http://creativecommons.org/publicdomain/zero/1.0/ Background Aim Study design Methods Results Conclusions