The normal spine is straight from behind and S-shaped from the side. This is what doctors often call a forward bend of the neck, a backward bend of the chest, and a forward bend of the waist, which is a physiological bend. When parents touch their children’s spine carefully, they can often find abnormal curvature or kyphosis, asymmetry of the scapula and back, and uneven heights. Scoliosis or kyphosis may become more pronounced a few months after birth. There may also be an unequal height of the shoulders, asymmetry of the thorax, and a tilted trunk and pelvis. Congenital spinal anomalies should be considered if the child also has abnormal hair clusters on the back, shallow hollows, shallow hair sinuses, and coffee-like spots. Anomalies of the spine and spinal cord may also be associated with varying thicknesses of the lower legs, different sizes of the feet, and impaired movement of the toes. All of these signs suggest the presence of an underlying spinal or spinal cord developmental malformation and require a visit to the pediatric clinic to confirm the diagnosis. Note that out-of-town patients can consult with me by phone before visiting the clinic to avoid not being able to get a number or not being suitable for the examination when they arrive. In older children, especially adolescent girls, if they often complain of back pain, they should take off their clothes and check the physiological curvature of the spine from the back, see if the occipital nodes are deviating from the mid-gluteal sulcus, and observe if the thoracic breasts are asymmetrical. If abnormalities are found, consider whether there is idiopathic scoliosis, and should be promptly hospital examination or film to confirm the diagnosis. If you have questions about this, feel free to book a phone consultation with me one-on-one communication, I will try to talk to you on the same day to solve your problems.