DOI: https://doi.org/10.36347/sasjm.2026.v12i03.015

Pages: 241-245

The aeronautical environment imposes multiple physiological, biomechanical, and psychological constraints on aircrew, particularly pilots, including high accelerations, pressure variations, vibrations, hypoxia, operational stress, and prolonged postures. These factors can precipitate or exacerbate conditions that may compromise flight safety. Aerospace medicine aims to maintain the highest level of safety by ensuring the physical and psychological fitness of aircrew through systematic medical evaluations at initial selection and periodic follow-up, with frequency adapted to the aeronautical specialty. The fundamental principle is that every aircrew member must be free from conditions that could be aggravated by flight or lead to sudden in-flight incapacitation, with an acceptable risk threshold classically set at less than 1%. To achieve this, a range of complementary investigations is integrated into initial assessments and follow-up protocols, with conventional radiography playing a central role. Radiography allows the detection of pulmonary diseases, including structural, infectious, or functional abnormalities; identification of musculoskeletal disorders, particularly of the spine; and the recognition of vesicorenal lithiasis on abdominal plain films. These conditions, often asymptomatic in their early stages, can nevertheless impair in-flight performance and pose a significant threat to aviation safety. In this context, conventional radiography serves as a strategic tool for triage, diagnostic orientation, and longitudinal surveillance in assessing aeromedical fitness, supporting targeted interventions to preserve operational readiness and safety. This ongoing practice raises an important question in contemporary aviation medicine: Does standard radiology truly help prevent in-flight incapacitation, or is it maintained more as a matter of regulatory tradition than as an evidence-based measure?