Scoliosis is the most common pediatric spinal deformity. Adolescent idiopathic scoliosis (AIS) comprises more than 80% of scoliosis and is influenced by genetic factors. Exome sequencing from 1,221 individuals with severe AIS (spinal curvatures ≥ 35 degrees) revealed aggregation of rare variants in several genes, including RAF1 (Noonan Syndrome), FBN1 (Marfan syndrome), and FNDC1 (previously associated with joint hypermobility). The enrichment of variants in FNDC1  was replicated in an independent Geisinger MyCode cohort. Fish studies suggest a role for FNDC1 in bone mineral density indicating a potential mechanism. (By Dr Christina A Gurnett, https://jmg.bmj.com/content/early/2025/04/29/jmg-2024-110586 )