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Interpretation of Normal Foot and Ankle Radiographs by Accident & Emergency and Orthopaedic Clinicians

Akhtar A, Davenport J, George C and Platt S

The purpose of this study was to assess the ability of clinicians dealing with foot and ankle trauma to interpret plain radiographs of the foot and ankle in standard views. A survey of 47 clinicians was conducted between November and December 2010. House officers, senior house officers (SHOs) and specialist registrars (SpRs) from the Emergency and Orthopaedic departments were recruited. Participants were supervised identifying 12 standard bones/landmarks on four images of normal foot and ankle radiographs. A significant difference was found between Emergency and Orthopaedics clinicians (p=0.01), in favour of the Orthopaedic group. Emergency SHOs correctly identified only seventy per cent of the structures assessed in this study. Orthopaedic trainees scored higher. Failure to recognize these bony landmarks may give rise to problems regarding the identification of fractures and dislocations. There is a deficiency in the knowledge and application of radiographic anatomy across Emergency clinicians, particularly evident in SHOs.