Should all casualty radiographs be reviewed?

Abstract

reports on radiographs of the chest, face, skuli, and wrist had the greatest effect on management of patients, while reports on radiographs of fingers, hands, shoulders, long bones, and toes seldom altered treatment.

Can more efficient use be made of x ray examinations in the accident and emergency department?

“…We strongly support earlier recommendations that all radiographs taken in the casualty department should be reviewed by an experienced radiologist. [13][14][15][16] Common injuries of the extremities (elbow, wrist, hand, ankle, and foot) provided most of the radiological errors in this study. Radiographs of the elbow, wrist, and ankle most often produced errors of clinical importance, in agreement with earlier studies. "…”

How good are emergency department Senior House Officers at interpreting X-rays following radiographers?? triage?

“…A marked variation is found in the reported figures: for ED physicians, the false negative rates (FNRs) range from 0.5 to 5% [2,[4][5][6][7][8][9] and the false positive rates (FPRs) range from 1.2 to 11.4% [2]. Radiographers' diagnostic performance has also varied with FNR ranging from 4.5 to 4.6% [2,10] and FPR from 2.5 to 4.7% [2].…”

Audit of litigation against the accident and emergency radiology department

“…We feel that it is useful to recommend that the radiologist note in the report any technical difficulties encountered during the examination, emphasising how the resulting radiographs cannot be used to rule out the presence of anything but patently evident lesions and inviting the requesting physician to have the patient undergo the examination again once stabilised, if necessary. With regard to the second episode, availability of a more appropriate device for the study of obese subjects might have 6% [10][11][12]. Per quanto riguarda le fratture, due lavori affrontano specificatamente il problema riportando valori che vanno dal 2,8% al 3,7% [13,14].…”

“…The percentage of misdiagnoses varies in the different studies from 1% to 6% [10][11][12]. With regard to fractures, two studies deal with this specific problem and report a rate of diagnostic error ranging from 2.8% to 3.7% [13,14].…”