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Materials and methods We studied 73 posteroanterior routine thoracic X-rays in patients with no signs of scoliosis. The difference in shoulder height is measured as the perpendicular distance from the upper surface of the acromial end of the left clavicle and the horizontal level of the upper surface of the acromial end of the right clavicle. Shoulder asymmetry was defined as any value of this distance greater than 1 cm. First rib asymmetry was assessed by the FRI. FRI is the difference between left and right 1st rib radius, measured from the centre of the vertebra of the corresponding level (usually T2) to the most distal point of the rib arch.

First rib asymmetry and shoulder imbalance – assessment of first rib index (FRI) in thoracic X-rays of people without scoliosis