THE IMPACT OF ANKLE RADIOGRAPHS ON THE DIAGNOSIS AND MANAGEMENT OF ACUTE ANKLE INJURIES

Rationale and Objectives. We assessed the impact of ankle radiographs on referring physicians' diagnoses and treatment of acute ankle injuri es. Methods. Twenty emergency department physicians prospectively comp leted questionnaires before and after radiography on 101 patients with acute trauma receiving ankle radiographs. The questionnaires asked ph ysicians to estimate the probability (0-100%) of their most likely dia gnosis before and after receiving the radiographic information. We als o asked their anticipated and final treatment plans. We calculated the mean gain in diagnostic confidence percentage and the proportion of p atients with changed initial diagnoses or anticipated management. Resu lts. The mean gain in diagnostic certainty from ankle radiographs was 34% (95% confidence interval [CI]=28-40%). Ankle radiographs changed p hysicians' initial diagnoses in 37% (95% CI=28-47%) of the patients. I mmediate clinical management changed in 30% (95% CI=22-40%) of the pat ients. Conclusion. Plain ankle radiographs have considerable impact on referring physicians diagnoses and treatment of acute ankle trauma.