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Am Fam Physician. 2002;66(11):online-only-

to the editor: We read with interest the article on adolescent idiopathic scoliosis by Dr. Greiner1 in American Family Physician. We share Dr. Greiner’s consternation regarding school system diagnosis of idiopathic scoliosis.

An interdisciplinary longitudinal study of the effects of distraction rehabilitation for otherwise untreated spinal curves is being conducted by the Island Coast Pain and Rehabilitation associates with Florida Gulf Coast University’s Department of Physical Therapy and a number of cooperating clinics. In the process, we have become somewhat alarmed at the absence of any meaningful pattern of referral from school screenings, although there are some noteworthy exceptions.

We agree with the observation that radiographs are critical in the diagnosis and measurement of treatment effectiveness when various forms of physical therapy are employed. Radiographs are the “gold standard” in the field. We are examining the correlated methods of back mapping with Pneumex equipment (Pneumex, Inc.; Sandpoint, Ida.), which has been studied by Richard Gajdosik, PT, Ph.D., at the University of Montana, Missoula, as a component of a graduate program in physical therapy, as well as the value of moiré topographic photography. We would urge continued comparative examination of these and other techniques as they become available.

As part of our study, we look forward to furthering the interest of family physicians in the early and accurate diagnosis of idiopathic scoliosis.

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This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

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