Diagnosis and Evaluation Using X-ray in Chuna Manual Therapy: A Scoping Review

Objectives This study aimed to identify and classify the patterns of x-ray utilization in chuna manual therapy (CMT) research, focusing on diagnostic purposes, evaluative applications, and the theoretical bases underlying radiographic assessment.Methods A scoping review methodology was employed in accordance with PRISMA-ScR guidelines.Studies published up to August 18, 2025, were searched in domestic databases and international ones.Study selection followed a stepwise screening process based on predefined inclusion and exclusion criteria, and any disagreements were resolved through discussion with a second reviewer.Results A total of 52 studies were included.More than half focused on various type of scoliosis (52.1%), in which Cobb's angle was the most frequently applied radiographic parameter, often supplemented by indicators such as Nash-Moe method.Other conditions included lumbar instability, cervical malalignment, pelvic imbalance, and sacroiliac joint disorders, with corresponding measures.X-ray was used solely for diagnostic purposes in 4/52 studies (7.7%), while most also employed it to evaluate treatment outcomes (92.3%).Conventional radiographic criteria were commonly applied, but several studies introduced CMT-specific or digital marker-based indicators, reflecting efforts to integrate traditional diagnostic perspectives with radiological assessment.Conclusions X-ray has been consistently utilized in CMT research as both a diagnostic tool and a means of evaluating treatment outcomes.This scoping review underscores the clinical value of x-ray in CMT and suggests that future research should focus on establishing standardized radiographic indicators, conducting multicenter studies across diverse contexts, and incorporating digital or AI-based analytic methods to strengthen evidence for clinical practice. (