Interpretation of radiographs in a pediatric limb deformity practice: Do radiologists contribute?

Orthopaedic surgeons make treatment decisions based on their interpretation of patient radiographs. Radiologists' reports of these radiographs are rou tine but may add little to the patient's management. The authors prospectiv ely compared data initially recorded by a pediatric orthopaedist in the ass essment of teleoroentgenograms obtained over a 3-month period in a Limb def ormity clinic with the subsequent reports of these studies by pediatric rad iologists. Two hundred and sixty-four (100%) anatomic axes of femora and ti biae were measured and reported by the surgeon compared to 1.9% by the radi ologist. Limb lengths were recorded 100% of the time by the orthopaedist an d by the radiologist in 80% of cases. Abnormal bone quality was present in 43 of 264 (16.2%) limb segments and reported in all involved cases by the o rthopaedist. Only 26 (9.8%) of the abnormalities were noted by the radiolog ist. Only eight of 20 (35%) physeal abnormalities such as rickets were note d by the radiologist in contrast to 20 of 20 (100%) noted by the surgeon. T here were no findings described by the radiologist not previously reported by the orthopaedic surgeon. In no case did the radiology interpretation inf luence clinical management decisions.