Risser sign - trends in a South African black population
The 5 stages of the Risser sign, which chart the development of ossification of the iliac crest has been widely used as a tool to assess skeletal age and remaining spinal growth, and thereby influence scoliosis management. However, as with other markers of skeletal age, it is under the influence of genetic and environmental factors. Proof of this was given by Risser, who observed that children in warmer climates developed earlier. Numerous other authors have also shown differences for other measures of maturity between different race groups. We tried to show that a different trend occurred in the South African Black population, as compared to published data from other population groups. Radiographs from the Radiology records departments of various hospitals were assessed by 2 independent observers for the Risser sign. This was used to chart trends, which was compared to trends published by Scoles et. al. which was recorded on the Cleveland based Brush-Bolton Collection. The South African black population showed a trend towards starting earlier. They however completed their fusion later. This is suggestive of a longer duration of iliac ossification. Furthermore, the importance of climatic control was shown by the fact that the black & white populations mirrored each other.
M.Med. (Orthopaedics), Faculty of Health Sciences, University of the Witwatersrand, 2011
Risser sign , scoliosis management