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Optimising and improving the quality of large joint radiographs: An educational interventional analysis
1Department of Diagnostic and Intervention Radiology, AIIMS Rishikesh, Rishikesh, India.
Introduction:
Projection radiographs play a crucial role in diagnosing musculoskeletal conditions, particularly in major joints like the knee, shoulder, and pelvis with bilateral hips. However, poor-quality radiographs can result in misdiagnoses, unnecessary repeat imaging, radiation exposure, and treatment delays. This study aimed to evaluate and enhance radiographic adequacy through targeted interventions.
Methods:
This study analysed 770 radiographs of the knee, shoulder, and pelvis, with 376 (48.83 %) from before the intervention and 394 (51.17 %) afterwards over 18-month period. A predefined adequacy scoring system was used, and radiographs were evaluated for adequacy pre-and post-intervention by a radiology resident in-training and an expert musculoskeletal radiologist with more than 10 years of experience. Interventions included a teaching session for radiographers on patient positioning, collimation, and exposure settings, along with instructional posters in radiography rooms. Adequacy rates and quality-influencing factors were statistically analysed, applying a significance threshold of p < 0.05.
Results:
Before the intervention, 64.9 % (244 out of a total of 376) pre-intervention radiographs were classified as adequate, while the remaining 35.1 % were inadequate, primarily due to improper positioning (79.3 %), poor collimation (12.1 %), or a combination of both (8.6 %). Post-intervention, adequacy rates significantly increased to 89.6 % (353 out of a total of 394) (χ2 = 67.384, p < 0.001). The likelihood of obtaining an adequate radiograph rose substantially in the post-intervention group, with odds 4.66 times greater than in the pre-intervention group. Improvements were most pronounced in the lateral knee, external rotation view of the shoulder and frontal pelvic radiographs.
Conclusion:
This study demonstrates the effectiveness of targeted educational interventions in significantly enhancing radiographic adequacy.
Implications For Practice:
Implementing educational programs for radiographers can lead to improved imaging quality, ultimately enhancing patient care.
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