Indications

Adam’s sign is a thoracic spine examination procedure that identifies structural or functional scoliosis. Also known as the Adam’s forward bend test, it is the most common technique used in school screening for scoliosis.  

Procedure

Patient should be awake and responsive as she is tested for Adam’s Sign.

  1. Patient stands as the test is done.
  2. The patient bends forward from the waist until her  back becomes a horizontal plane. Her feet must be together with arms hanging along the sides and knees extended. The examiner may otherwise tell the patient to touch her toes and remain in the position.
  3. The examiner checks the patient’s back, along the horizontal plane of the column vertebrae. He looks for spinal and scapular asymmetry, non-level shoulders and hips or a rib hump.
  4. After examining the patient, the examiner assists the patient to return to a standing position.

The patient bends forward to touch her toes for the examination.

Interpretation

Positive Adam’s Sign

A rib hump when a patient bends forward to touch his toes is a positive Adam’s Sign. This indicates scoliosis.

Clinical Notes

Adam’s Sign is one of the initial thoracic spine tests for scoliosis. A quantitative measurement of the degree of scoliosis may be taken using x-rays. This is called the Risser-Ferguson Method. A scoliometer may also be used.