What is the best way to determine the cause of adolescent idiopathic scoliosis?

Adolescent idiopathic scoliosis (AIS) is defined as a lateral deviation of the spine associated with rotation that is found in healthy individuals and has no known cause. These subjects do not exhibit neuromuscular conditions or other disorders until the onset of sexual maturation at approximately 10 years of age (1). Diagnosis is challenging; radiography reveals curves of more than 10 degrees by Cobb method (2) without vertebral abnormalities. Additionally, the angular deviation required for diagnosis is controversial, which further complicates diagnosis. In 1995, Winter questioned the accepted diagnostic value used to characterize the disease and proposed that a curve of 5 degrees should be considered pathological or a variation from a normal spine (3). Furthermore, it is important to observe how rotation impacts the condition, as this feature may be more characteristic of the disease than the curvature itself.