Risser Sign (US and French Systems)

Risser (1958) - US 0-5 and French 0-4 variants

Estimates remaining skeletal growth from ossification and fusion of the iliac apophysis on a frontal pelvis or scoliosis radiograph. Both grading traditions are supported: the US system (stages 0-5, dividing the crest into quarters) and the French system (stages 0-4, dividing it into thirds).

Also searched as: scoliosis · skeletal maturity · iliac apophysis · pediatric · classification · orthopedic

Information

Incomplete input

Select which Risser system is being used: US (0-5) or French (0-4).

How this tool works

The Risser sign helps predict the risk of scoliosis curve progression by gauging skeletal maturity. Two versions coexist and must not be interchanged: the US system divides apophyseal excursion into quarters of the iliac crest (stages 1-4) and reserves stage 5 for complete fusion, whereas the French system divides excursion into thirds (stages 1-3) and uses stage 4 for the fusion period. For the same film the French system therefore assigns one fewer stage to equivalent fusion. The sign is read on an anteroposterior radiograph, beginning at the anterolateral (superolateral) crest and progressing posteromedially; it correlates with, but is less precise than, hand-based skeletal age or modern maturity scores.

References

Hacquebord JH, Leopold SS. In Brief: The Risser Classification: A Classic Tool for the Clinician Treating Adolescent Idiopathic Scoliosis. Clin Orthop Relat Res 2012;470:2335-8.

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

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