Use of radiology by general practitioners making orthopaedic referrals: a cross-sectional study

In orthopaedic clinics, patients can be x-rayed during their visit to the surgeon. Could radiographs carried out in primary care be more efficiently carried out when the patient meets the surgeon?

To quantify and describe use of radiological investigations by general practitioners (GPs), when referring to orthopaedics.

We made a retrospective examination of 294 referral letters for detail regarding x-ray investigation of the condition prompting the letter. We used referral letters assessed by the recipient as 'routine'. We excluded those addressed to a particular surgeon because of subspecialty interest or prior care.

Twenty one percent (62) of referrals described an investigation that did not contribute to management prior to the patient's clinic appointment.

A significant number of patients travelled specifically for an x-ray. In some of these cases the radiographs could be delayed until the clinic visit without compromising care.

We suggest that GPs seeing patients with musculoskeletal problems should consider referral to an orthopaedic surgeon prior to requesting x-rays. X-ray investigation in the orthopaedic clinic may be more convenient for the patient and surgeon.