Comparing Perceived Radiograph Quality Between Radiologic Technologists and Orthopedic Surgeons

To determine if there is a discrepancy between how orthopedic surgeons perceive the quality of plain radiographs compared with that of radiologic technologists.

A prospective survey was developed including 42 deidentified plain radiographs. Included radiographs were of varying anatomical regions, patient positioning, and radiographic parameters. Participants were requested to score each radiograph on a scale from 1 (very poor) to 100 (very good) based on their overall subjective definition of radiographic quality.

Multiple analyses of variance showed that out of the 42 radiographs evaluated, 13 images had significant differences in how they were scored by each group. Technologists provided lower image quality scores for 11 images compared with the orthopedic residents and attending surgeons. Two images were scored significantly higher by the attendings compared with the technologists or residents. Of the 42 images, 29 were scored similarly by the 3 groups.

This study is novel because it explored perceived radiograph quality between attending orthopedic surgeons, orthopedic surgery residents, and radiologic technologists. Review of current literature revealed comparisons of radiography quality assessments between radiologic technologists and radiologists. Like the findings of the authors of the current report, the literature analysis demonstrated that radiologic technologists and radiologists appear to agree on what was considered a quality image, but technologists were more reluctant to accept images of lower quality than were radiologists. These authors believe the present study helps further establish that orthopedic surgeons typically order repeat imaging for reasons other than image quality.

Orthopedic surgeons and radiologic technologists appear to agree in a subjective manner on a quantitative scale. Radiologic technologists tended to be more critical than were orthopedic surgeons in judging radiograph quality, contrary to the authors' original hypothesis.