What is the Risser scale
This information is for general education. If you suspect scoliosis, consult your GP or orthopaedic specialist for formal medical diagnosis.
The Risser scale is a way of estimating skeletal maturity using an X-ray of the pelvis. It looks at how much of the iliac crest (the top of the pelvic bone) has turned from cartilage into bone, which is known as ossification.
The scale goes from 0 to 5:
- Risser 0: no ossification yet (usually earlier in growth)
- Risser 1 to 4: progressive stages of growth during puberty
- Risser 5: full skeletal maturity (growth has stopped)
The Risser grade is often recorded on a standard pelvic X-ray, and it may be available alongside other measurements, such as the Cobb angle.
In general:
- Risser 1 marks the start of puberty
- Risser 3 is around the middle of puberty
- Risser 5 signals that growth is complete
Puberty timing varies from person to person, but as a general guide:
- girls usually begin puberty between 11 and 12 and finish by 16 or 17.
- boys start slightly later, around 12 or 13 and typically finish between 17 and 18.
Why does the Risser scale matter in scoliosis treatment?
If your child has scoliosis, their Risser grade can help indicate how much growth they may have remaining. This is important because a scoliosis curve may be more likely to progress during periods of rapid growth.
Bracing is generally most effective while a child is still growing, which means that identifying the appropriate time to begin treatment is important.
You can learn more about the factors associated with curve progression in our guide to understanding scoliosis progression.
How LOC considers skeletal maturity
Skeletal maturity can help indicate how much growth a child has remaining and the likelihood of their scoliosis curve progressing.
At LOC, our orthotists consider the Risser grade alongside other relevant factors, including the Cobb angle, age, stage of growth and information provided by the child’s medical team. Together, these factors help us assess whether bracing may be suitable and inform an individual orthotic treatment plan.
If you already have a medical report or recent X-rays, our orthotists can review the available measurements and explain what they may mean for orthotic treatment.
Not sure what your child’s Risser grade means for bracing?
Book a free online consultation with one of our specialist orthotists. We can discuss the measurements contained in your child’s medical report, explain whether bracing may be suitable and outline the possible next steps. Book a free online assessment.
Spotting scoliosis early
Scoliosis can develops gradually, which can make early signs easy to miss. Knowing what to look for can help you spot changes sooner. The image below highlights some common visual signs that may indicate scoliosis.
