These landmarks were the spinous process of C7 (2), spinous process of S1 (8), acromial angle of the shoulders (AAOS) (0, 4), superior angle of the scapula (SAOS) (1, 3), inferior angle of the scapula (IAOS) (5, 6), and the posterior superior iliac spine (PSIS) (7, 9), as suggested by the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) [ 17].
The study thus included 21 (31%) patients with GHD and PSIS (Table 1), 76% of them boys.
Light-emitting diodes (LED) were positioned on the right side and back of the participant on 8 anatomical landmarks: (a) external malleolus; (b) Gerdy's tubercle; (c) lateral condyle of the femur; (d) greater trochanter; (e) anterior superior iliac spine (ASIS); (f) posterior superior iliac spine (PSIS); (g) L1; (h) T11.
Assessment of flexion and extension movements by straight palpation of bony landmarks as in the Straight palpation of PSIS and L1 method (ICC: Flexion 0.60; Extension 0.74) was found to be marginally less reliable than the other two landmarking measurement strategies (ICC: Flexion 0.66; Extension 0.76).
The modification consisted of a reduction in the 2 posterior markers on the left and right posterior superior iliac spine (PSIS) into 1 marker on the sacrum, positioned at the mid-point between the left and right PSIS. 1 marker on the left and right anterior superior iliac spine completed the pelvic segment.
There were 334 patients after excluding non-surgical patients for PSI 12 EP/DVT and PSI 13 sepsis (see figure 1) and 163 patients after excluding those with PSIs present on admission.
In the second part of the protocol, the local system was established using reference marks of the PSIS and T8, the origin of which is located at the midpoint between the two PSIS.
The PSIS encompasses 12 items that assess four aspects of suicide intent: self-harm context (item 1 4), suicide warning signs (item 5 6), subjective perceptions (item 7 10), and medical seriousness (item 11 12).
In other circumstances, GHD is readily diagnosed when magnetic resonance imaging (MRI) shows pituitary stalk interruption syndrome (PSIS) [ 1] and/or if there is microphallus, hypoglycemia, other hypothalamic-pituitary deficiencies, or genetic causes.
We recommend the use of the PSIS to 15 cm cephalad method as used in the modified-modified Schobers test as it is the simplest to perform and aligns with current clinical practice.
However, from a clinical standpoint, the PSIS to 15 cm cephalad method as used in the modified-modified Schobers test, is recommended, as it is the simplest to perform and aligns with routine clinical practice.
