What is often the first sign of idiopathic scoliosis in children?

The first sign of idiopathic scoliosis in children is often the appearance of uneven shoulders or hips. Scoliosis involves an abnormal lateral curvature of the spine, which can lead to changes in posture and the alignment of the shoulders and hips. As the spine curves, one shoulder may appear higher than the other, or one hip may be elevated. These visual asymmetries can often be the most noticeable early indicator of the condition.

Back pain, while a symptom associated with scoliosis, typically develops later in the progression of the condition and is not usually the initial sign, especially in children. Difficulties in walking and muscle cramps are also not common early indications of scoliosis; these symptoms might arise due to other orthopedic issues or complications but are not characteristic signs of the condition itself. Thus, uneven shoulders or hips serve as the first observable manifestations of idiopathic scoliosis in a child, prompting further evaluation.