Value of re-examining x-ray films of outpatients attending accident services

X-ray films of 4,665 patients who had attended an accident service as outpatients were reviewed by the clinicians and reported on by the radiologist the next day.In 20 cases the radiologist did not comment on bony injuries which had been diagnosed and treated by the accident service senior house officer. The radiologist, however, detected bony injuries which had been missed by the accident service senior house officer in 26 cases. In 10 cases injuries which had not been detected at the original examination or by the radiologist were noted when the x-ray films were reviewed. On two occasions the fracture was missed at all three examinations.The daily joint review of x-ray films by accident service officers and the radiologist seemed to increase the clinical and radiological acumen of the staff of the accident service.