Communicating traumatic pathology to ensure shared understanding: is there a recipe for the perfect preliminary image evaluation?

Abstract

Medical imaging and emergency departments work collaboratively to interpret trauma radiographs. In addition to accurate radiographic interpretation, clear communication is crucial to ensure appropriate and timely management of musculoskeletal injuries. This two-step 'how to guide' provides the reviewer with a recipe for effectively evaluating trauma radiographs for traumatic pathology and succinctly documenting the findings.Step 1 is a systematic search of the radiograph: soft tissues, bones, alignment of joints and satisfaction of search (SBASS). Utilising SBASS increases reviewer confidence in identifying traumatic pathology of the appendicular and axial skeleton.Step 2 is a streamlined communication model for the documentation of pathological findings. The WWW acronym (What is it? Where is it? What is it doing?) can be adapted to describe simple or complex traumatic pathology.

An analysis of radiographer preliminary image evaluation – A focus on common false negatives

“…The S stands for 'Soft Tissue', B for 'Bones', A for 'Alignment of Joints' and SS for 'Satisfaction of Search'. 28 Table 4. The pathology present for False-negative/ True-positive category PIEs for multiple injuries.…”

“…The importance of ongoing searching for abnormalities is not a new concept, with errors relating to multiple injury examination being termed ‘Satisfaction of Search’ or Subsequent Search Miss (SSM). 27 , 28 In an Australian publication, 28 the SBASS systematic search strategy was introduced with a step incorporated to specifically remind health professionals to search for multiple pathology. This strategy captures the key components to search when interpreting radiographs.…”

“…The S stands for ‘Soft Tissue’, B for ‘Bones’, A for ‘Alignment of Joints’ and SS for ‘Satisfaction of Search’. 28 The ‘Satisfaction of Search’ or SSM component of this strategy is there to remind the interpreter not to conclude searching for abnormalities once an initial one is visualised. 28 Therefore, the findings from the current study further demonstrate the importance of the ‘Satisfaction of Search’ element within the SBASS strategy.…”

“… 28 The ‘Satisfaction of Search’ or SSM component of this strategy is there to remind the interpreter not to conclude searching for abnormalities once an initial one is visualised. 28 Therefore, the findings from the current study further demonstrate the importance of the ‘Satisfaction of Search’ element within the SBASS strategy. Whilst the aim of this research was to demonstrate the common interpretive errors within the specific anatomical regions, a main cause of these errors may be unidentified subsequent injuries rather than the misinterpretation of pathology in a specific region.…”