Objective: Senior author conducted two studies focusing on the age of presentation, Cobb angle at presentation and means of detection of adolescent idiopathic scoliosis in 1976 and 1985 respectively. We conducted another similar study in 1999 to compare the present situation with the previous two studies.

Design: Data was collected for 100 consecutive cases of adolescent idiopathic scoliosis which presented to the scoliosis clinic at The Middlesex Hospital, London from 1997 to 1999. the age of presentation, Cobb angle at presentation and the person who detected the deformity first were recorded. The patients were divided in following groups.

Group1 detected by family and friends.

Group2 detected by GP or by another doctor incidentally.

Group3 detected at school.

Group 4 detected by teachers.

Subjects: There were 81 female and 19 male patients with a mean age of 13.8 years.

Results: Group 1 consisted of 63% of the patients. Group 2 had 26% of the patients. Group 3 compromised of 8% of the patients and group 4 had 3% of the patients. Group 1 was the largest group and had increased since 1985 and 70% of the patients in this group had a Cobb angle greater than 40 degrees at presentation. It was also noted that group 3 had significantly dropped to 8% while in 1985 and in 1976 it was 10% and 32% respectively.

Conclusions: Our results represent a small sample from one center but it clearly shows that detection of scoliosis at school has dropped and majority of the cases are detected by family and friends often at a later stage with larger Cobb angles in excess of 40 degrees. Non-operative methods are ineffective with Cobb angles of this magnitude thus highlighting the importance of some means of early detection of scoliosis and producing greater awareness in the community.