{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T07:23:51Z","timestamp":1767857031665,"version":"3.49.0"},"reference-count":15,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Given the prevalence of scoliosis, it is essential for residents in Physical and Rehabilitation Medicine to develop proficiency in evaluating spinal radiographs, particularly in measuring the Cobb angle. This education and training study aimed to define the minimum educational requirements for residents to achieve competency in Cobb angle measurement with acceptable inter- and intra-operator variability, as reported in the literature. Methods: In this ethics-approved study, Physical and Rehabilitation Medicine residents measured Cobb angles and the Risser index using specialized software on 30 different spinal X-rays, with oversight to ensure consistency and eliminate bias. Results: The data revealed that 44.4% of residents achieved the target accuracy for primary Cobb angles (&lt;3.6\u00b0), but only 11.1% did so for secondary curves. For intra-operator error, 88.9% of residents met the target for primary curves, but only 11.1% achieved the target for secondary curves. The Risser index showed minimal deviation across all participants. Conclusions: These findings highlight that mastering Cobb angle measurement is challenging and generally requires more than 20 different measurements for inter-operator reliability and over 30 repetitions for intra-operator reliability, particularly when secondary curves are included.<\/jats:p>","DOI":"10.3390\/jcm14030911","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T05:40:46Z","timestamp":1738215646000},"page":"911","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Training for Radiographic Assessment of Scoliosis: A Pilot Educational Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5930-5974","authenticated-orcid":false,"given":"Mirko","family":"Filippetti","sequence":"first","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, ON K7K 1Z6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Tomasello","sequence":"additional","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8017-4013","authenticated-orcid":false,"given":"Rita","family":"Di Censo","sequence":"additional","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Department of Neurosciences, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Modenese","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-2288","authenticated-orcid":false,"given":"Dalila","family":"Scaturro","sequence":"additional","affiliation":[{"name":"Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Letizia Mauro","sequence":"additional","affiliation":[{"name":"Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4242-8497","authenticated-orcid":false,"given":"Valentina","family":"Varalta","sequence":"additional","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Department of Neurosciences, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-1887","authenticated-orcid":false,"given":"Nicola","family":"Smania","sequence":"additional","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Department of Neurosciences, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-8276","authenticated-orcid":false,"given":"Alessandro","family":"Picelli","sequence":"additional","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, ON K7K 1Z6, Canada"},{"name":"Department of Neurosciences, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Caesarendra, W., Rahmaniar, W., Mathew, J., and Thien, A. (2022). Automated Cobb Angle Measurement for Adolescent Idiopathic Scoliosis Using Convolutional Neural Network. Diagnostics, 12.","DOI":"10.3390\/diagnostics12020396"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13013-017-0145-8","article-title":"2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth","volume":"13","author":"Negrini","year":"2018","journal-title":"Scoli. Spinal Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100921","DOI":"10.1016\/j.ijotn.2022.100921","article-title":"A systematic scoping review and textual narrative synthesis of the qualitative evidence related to adolescent idiopathic scoliosis","volume":"45","author":"Essex","year":"2022","journal-title":"Int. J. Orthop. Trauma Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Jin, C., Wang, S., Yang, G., Li, E., and Liang, Z. (2022). A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors, 22.","DOI":"10.3390\/s22093258"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"E780","DOI":"10.1097\/BRS.0b013e3181f0825a","article-title":"Reliability and accuracy analysis of a new semiautomatic radiographic measurement software in adult scoliosis","volume":"36","author":"Aubin","year":"2011","journal-title":"Spine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1097\/01.brs.0000217774.13433.a7","article-title":"Comparison of manual and digital measurements in adolescent idiopathic scoliosis","volume":"31","author":"Kuklo","year":"2006","journal-title":"Spine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s12178-012-9116-0","article-title":"Early onset scoliosis: Current concepts and controversies","volume":"5","author":"Fletcher","year":"2012","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1097\/00007632-200007150-00010","article-title":"Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis?","volume":"25","author":"Betz","year":"2000","journal-title":"Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1097\/BRS.0b013e318166aa8d","article-title":"Comparison of observer variation in conventional and three digital radiographic methods used in the evaluation of patients with adolescent idiopathic scoliosis","volume":"33","author":"Mok","year":"2008","journal-title":"Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"447","DOI":"10.2106\/00004623-198365040-00004","article-title":"Curve progression in idiopathic scoliosis","volume":"65","author":"Weinstein","year":"1983","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.21037\/asj-21-105","article-title":"Inter- and intra-reliability of Cobb angle measurement in pediatric scoliosis using PACS (picture archiving and communication systems methods) for clinicians with various levels of experience","volume":"3","author":"Lucasti","year":"2023","journal-title":"AME Surg. J."},{"key":"ref_12","unstructured":"(2024, December 10). SRS Core Curriculum. Available online: https:\/\/www.srs.org\/Education\/Core-Curriculum."},{"key":"ref_13","unstructured":"(2024, December 10). ISPRM Education Committee: PMR Core Curriculum and Competency. Available online: https:\/\/isprm.org\/wp-content\/uploads\/2020\/02\/PRM-Core-curriculum-Competency_Final-11.29.19.pdf."},{"key":"ref_14","unstructured":"(2024, December 10). Italian Government \u201cMinistero dell\u2019Istruzione e del Merito\u201d, Available online: https:\/\/www.mim.gov.it\/-\/decreto-interministeriale-recante-gli-standard-i-requisiti-e-gli-indicatori-di-attivita-formativa-e-assistenziale-delle-scuole-di-specializzazione-di-."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1053\/j.ro.2024.06.001","article-title":"Artificial intelligence in musculoskeletal radiographs: Scoliosis, hip, limb length, and lower extremity alignment measurements","volume":"59","author":"Archer","year":"2024","journal-title":"Semin. Roentgenol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/911\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:38:50Z","timestamp":1759919930000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,30]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030911"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030911","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,30]]}}}