Paper| Volume 23, ISSUE 1, P47-50, 1992

Value of radiograph audit in an accident service department

      This paper is only available as a PDF. To read, Please Download here.


      In our accident service department all trauma radiographs are reported acutely and those misinterpreted by the casually officers are presented at the daily clinicoradiological conference. We have reviewed this practice over a 6-month period.
      From over 25000 patients attending the accident service, 16 246 radiographs were requested and reported. Of these, 456 (2.8 per cent) were considered to have been potentially misinterpreted. The errors included 167 (1 per cent) missed fractures, 55 (0.3 per cent) suspected fractures and 72 (0.4 per cent) false-positive diagnoses of fracture. Subsequently, 114 (0.7 per cent) patients required recall for treatment or further imaging. Incorrect diagnoses were seen most frequently in the more commonly injured anatomical sites — the ankle, wrist, foot, elbow and hand. However, the incidence of misinterpretation was highest in examination of the fingers, especially in children.
      We believe that these low figures are principally the result of involving both orthopaedic surgeons and radiologists at the formal daily conference. We regard our system of audit as beneficial to patients' care and anticipate reduced litigation which may offset the increased cost of audit.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Annis J.A.D.
        • Finlay D.B.L.
        • Allen M.J.
        • et al.
        A review of cervical spine radiographs in casualty patients.
        Br. J. Radiol. 1987; 60: 1059
        • Berman L.
        • de Lacey G.
        • Twomey E.
        • et al.
        Reducing errors in the accident department: a simple method using radiographers.
        Br. Med. J. 1985; 290: 421
        • Carew-McColl M.
        Radiological interpretation in an accident and emergency department.
        Br. J. Clin. Pract. 1983; 37: 375
        • de Lacey G.J.
        • Barker A.
        • Harper J.
        • et al.
        An assessment of the clinical effects of reporting accident and emergency radiographs.
        Br. J. Radiol. 1980; 53: 304
        • Galasko C.S.B.
        • Monahan P.R.W.
        Value of re-examining x-ray films of outpatients attending accident services.
        Br. Med. J. 1971; 1: 643
        • Gleadhill D.N.S.
        • Thomson J.Y.
        • Simms P.
        Can more efficient use be made of x-ray examinations in the accident and emergency department?.
        Br. Med. J. 1987; 294: 943
        • Mucci B.
        The selective reporting of x-ray films from the accident and emergency department.
        Injury. 1983; 14: 343
        • Rhea J.T.
        • Potsaid M.J.
        • DeLuca S.A.
        Errors of interpretation as elicited by a quality audit of an emergency radiology facility.
        Radiology. 1979; 132: 277
        • Robson N.
        • van Benthem P.P.
        • Gan R.
        • et al.
        Casualty x-ray reporting: a student survey.
        Clin. Radiol. 1985; 36: 479
        • Swain A.H.
        Radiological audit — changes in casualty officer performance during tenure of post.
        Br. J. Accid. Emerg. Med. 1986; 1: 5
        • Vincent C.A.
        • Driscoll P.A.
        • Audley R.J.
        • et al.
        Accuracy of detection of radiographic abnormalities by junior doctors.
        Arch. Emerg. Med. 1988; 5: 101
        • Wardrope J.
        • Chennells P.M.
        Should all casualty radiographs be reviewed?.
        Br. Med. J. 1985; 290: 1638