Risser sign

1. See Also

   1. Tanner Stage
2. Indications
3. Skeletal Maturity estimation in Scoliosis evaluation
4. Scoliosis progression risk related to skeletal maturity
5. Physiology
6. Iliac apophysis calcification begins at Puberty
   1. Calcification completed over 2 year period
   2. Completed with apophysis fusion to iliac crest
7. Calcification (or ossification) begins anterolaterally
   1. Anterior superior iliac spine is first to calcify
   2. Calcification progresses posteromedially
8. Grading (based on iliac crest divided into 4 quadrants)
9. Risser 1: 25% iliac apophysis ossification
   1. Anterior Superior iliac spine (anterolateral)
   2. Seen in prepuberty or early Puberty
10. Risser 2: 50% iliac apophysis ossification
    1. Ossification extends halfway across iliac wing
    2. Seen immediately before or during growth spurt
11. Risser 3: 75% iliac apophysis ossification
12. Risser 4: 100% iliac apophysis ossification
    1. Adjacent to sacroiliac joint (posteromedial)
    2. Indicates slowing of growth
13. Risser 5: Iliac apophysis fuses to iliac crest
    1. Indicates cessation of growth