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Updated: Jan 4, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
Musculoskeletal Radiology Reports: Overlooked or Valuable?
Sadaf Sahraian1, Matthew D Alvin2, Arya Haj-Mirzaian2
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 600 N. Wolfe Street, Phipps B100F, Baltimore, MD, 21287, USA. dyousem1@jhu.edu.
Abstract:
The electronic medical record (EMR) can reveal preferences of clinicians regarding imaging services. We sought to evaluate viewing habits for reports and images of musculoskeletal (MSK) studies by ordering clinicians. We hypothesized that MSK reports are important to clinical management, especially for advanced imaging modalities. We tracked the image and report access of all MSK studies ordered in September 2016 over 8 months using logs of the EMR (Epic Systems, Verona, WI), and by an independent analysis of the institutional PACS (Picture Archiving and Communication Systems) (Carestream Health, Rochester, NY). The time stamps were extracted for when images and reports were viewed. We categorized MSK studies by modality and provider department. We also compared the rates of viewing reports and images among different modalities and departments using the chi-square test. Of the 8143 viewed MSK studies, 7842 (96.3%) reports (with/without images) and 3916 (48.1%) imaging data (with/without reports) were viewed. Viewing reports alone occurred in 4227 (51.9%) studies. CT and MRI reports alone views occurred more often in comparison to radiographs ([482/706; 68.3%] for CT and [981/1713; 57.3%] for MRI vs. [2764/5724; 48.3%] for radiography, p < 0.001). Orthopedists ordered the highest number of MSK studies and viewed reports 99.2% (3216/3242) of the time, including a 54.6% (1770/3242) rate of viewing reports alone and a 44.6% (1446/3242) rate of viewing both reports and images. They viewed images without reports in 0.8% (27/3242) of cases. MSK reports were viewed significantly more frequently than the images across all modalities and all relevant specialties.
Insights
Clinicians frequently access musculoskeletal (MSK) imaging reports, especially for CT and MRI studies, indicating their importance in patient care. Reports are viewed more often than associated images across all modalities.
Area of Science:
- Radiology and Imaging
- Health Informatics
- Clinical Decision Support
Background:
- Electronic Medical Records (EMR) offer insights into clinician preferences for imaging services.
- Understanding clinician viewing habits for musculoskeletal (MSK) imaging reports and images is crucial for optimizing workflow and patient care.
Purpose of the Study:
- To evaluate the viewing habits of ordering clinicians for musculoskeletal (MSK) imaging reports and images.
- To test the hypothesis that MSK reports are vital for clinical management, particularly with advanced imaging.
Main Methods:
- Utilized EMR (Epic Systems) and Picture Archiving and Communication Systems (PACS) logs to track access of MSK studies over 8 months.
- Extracted timestamps for image and report views, categorizing studies by modality and department.
- Employed chi-square tests to compare viewing rates of reports and images across modalities and departments.
Main Results:
- Of 8143 MSK studies, 96.3% had reports viewed, while only 48.1% had images viewed.
- Reports were viewed alone in 51.9% of cases; CT and MRI reports were viewed alone more frequently than radiographs.
- Orthopedists, the highest ordering group, viewed reports in 99.2% of cases, with 54.6% viewing reports alone and 44.6% viewing both reports and images.
Conclusions:
- Musculoskeletal (MSK) imaging reports are accessed significantly more often than their corresponding images across all modalities and specialties.
- The high rate of report viewing, especially for advanced imaging like CT and MRI, underscores their critical role in clinical decision-making.
- Clinician viewing patterns suggest a strong reliance on radiology reports for patient management.
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