Prevalence of Discrepancies Between Orthopedic and Radiology Impressions in Pediatric Musculoskeletal Radiographs

Document Type

Conference Proceeding

Publication Date

4-1-2022

Publication Title

Pediatr Radiol

Abstract

Purpose or Case Report: The radiologic interpretation of diagnostic imaging provides valuable information into the clinical workflow. At our institution, pediatric musculoskeletal images ordered by orthopedics and sports medicine are interpreted by the ordering clinician at the time of the clinic appointment and prior to the final radiology interpretation. Therefore, understanding potential discrepancies between orthopedic and radiology interpretations is vital. In this study, we sought to evaluate the rate of significant discrepancy in pediatric musculoskeletal radiograph interpretation for the purposes of quality improvement. Methods & Materials: 2169 pediatric musculoskeletal radiograph reports between 1/1/2017 to 12/30/2020 from a single hospital system sports medicine clinic were retrospectively reviewed for significant discrepancies in radiographic interpretation between orthopedic clinic notes and final radiology impressions. Significant discrepancies included fractures, dislocations, and spondylolistheses. Basic statistical analyses were performed to evaluate the prevalence of discrepancies in the entire data set and in the orthopedic and radiology subsets. Results: Of the 2169 studies, a total of 122 or 5.62% demonstrated a significant discrepancy between orthopedic and radiology impressions. Orthopedics reported positive findings in 79 out of the 122 discrepant studies (64.75%) where radiology did not. Radiology reported positive findings in 40 out of the 122 discrepant studies (32.79%) where orthopedics did not. Conclusions: While previous research has shown an overall radiology error rate of 3-5%, current understanding of the discrepancies between orthopedic and radiology impressions in pediatric musculoskeletal radiographs is limited. This lack of knowledge may have significant implications for the clinical management of pediatric musculoskeletal abnormalities. In this study, we uncovered a low overall rate of clinically significant discrepancy between orthopedic and radiology interpretations of pediatric musculoskeletal radiographs. However, in cases of discrepancy, orthopedists reported positive findings at approximately twice the rate of radiologists. Despite being a small number, these differences are important as they may result in both improper patient management and a negative patient impression of radiologists. Further research is currently underway to evaluate our hypothesized explanations for discrepancies as well as potential pathways to mitigate discrepancies in the future.

Volume

52

Issue

SUPPL 1

First Page

S24

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