The Risser sign looks at how the iliac bones are fusing and changing. Different Risser stages show varied levels of skeletal maturity and how much growth is possible. Among these, the Risser stage perhaps is the most widely used indicator for skeletal maturity.

Understanding the Context

Risser divided the steps of ossification and fusion of the iliac apophysis into six stages (Risser Stages 0–5), with the higher numbers describing advancement toward skeletal maturity. There are different ways to assess a patient’s scoliosis and help predict their progressive rate; Risser stage measures skeletal maturity and growth potential. The Risser stage is a 0-to-5 scoring system that tells doctors how close an adolescent is to being done growing. It works by looking at a specific strip of bone along the top of the pelvis, called the iliac apophysis, on an X-ray.

Key Insights

The Risser stage is a standardized classification system used by medical professionals to estimate a person’s skeletal maturity and remaining growth potential, typically visualized through X-ray imaging. The Risser sign (iliac aphosyseal fusion indicates vertebral growth completion) was first described in 1958 by Joseph C. Risser (1892–1982), an American orthopedic surgeon 3-5. In Brief: The Risser Classification: A Classic Tool for the Clinician ... How do I assess or understand a Risser sign?

Final Thoughts

Evaluating Risser sign to help estimate bone age (and thus skeletal maturity and risk for scoliosis progression) is easily done during a spine x-ray as the pelvis is imaged at the time of the spine.