Measurement of scoliosis by orthopedic surgeons and radiologists

Minimum medical standards for USAF flying personnel have been compiled in Air Force Regulation 160-43. This regulation specifies the maximum allowable amount of scoliosis, but does not specify who should read the X-ray film to determine, using the Cobb method, the degree of curvature in scoliotic individuals. In the present study, an X-ray of an individual with mild scoliosis was sent to departments of radiology and orthopedics at major U.S. Armed Forces Medical Centers. Although the mean estimated degree of curvature was the same for both the orthopedists and the radiologists, the variance in the radiologists' replies was considerably higher than normally expected. It is, therefore, recommended that scoliosis films of individuals being screened for flying duties should be reviewed by a qualified orthopedic surgeon.