The spine should be straight when observed from behind. There may be apparent asymmetry if the patient is not weight bearing equally on both legs and so this must be observed when assessing the back. "Postural roundback" mimics kyphosis and is common in adolescents who "slouch". This is correctable if the patient hyperextends the shoulders. The forward bend test will accentuate true scoliosis (viewed from behind) or fixed kyphosis (viewed from the side) while normally flexible spines will appear straight and symmetrical. from behind.
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