Scoliosis, leg length discrepancy, or both?

LLD and scoliosis can mimic or exacerbate one another, making careful evaluation essential in pediatric patients. True structural scoliosis must be differentiated from a functional scoliosis secondary to LLD. An accurate assessment of leg lengths should be part of the routine evaluation for any child with scoliosis. When a significant LLD is identified as the cause of spinal curvature, appropriate treatment, such as shoe lifts or surgical correction of the limb inequality, might correct the spinal curvature in the coronal plane. In contrast, in idiopathic scoliosis with a minor coexisting LLD, treatment should primarily address the spinal deformity.