Rotoscoliosis is a specific type of scoliosis that involves a significant rotational component in addition to the typical lateral curvature of the spine. Rotoscoliosis has distinct physical manifestations. Observing a patient from behind, one may notice asymmetrical waists, with one side appearing more indented and the other flat. When the patient bends forward, one shoulder blade may protrude more prominently than the other. Other signs include a tilted head and uneven hand placement due to unlevel shoulders.