Optimising and improving the quality of large joint radiographs: An educational interventional analysis

IF 2.5 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiography Pub Date : 2025-07-09 DOI:10.1016/j.radi.2025.103085

S. Puri, A. Syed, S. Saxena, B. Keshari, B.V. Madhuri, S. Saran

{"title":"Optimising and improving the quality of large joint radiographs: An educational interventional analysis","authors":"S. Puri, A. Syed, S. Saxena, B. Keshari, B.V. Madhuri, S. Saran","doi":"10.1016/j.radi.2025.103085","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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) (χ<sup>2</sup> = 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.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the effectiveness of targeted educational interventions in significantly enhancing radiographic adequacy.</div></div><div><h3>Implications for practice</h3><div>Implementing educational programs for radiographers can lead to improved imaging quality, ultimately enhancing patient care.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 5","pages":"Article 103085"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiography","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1078817425002299","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

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.

查看原文本刊更多论文

优化和提高大关节x线片的质量：一项教育介入分析

x线投影片在诊断肌肉骨骼疾病中起着至关重要的作用，特别是在膝关节、肩部和双侧髋关节等主要关节中。然而，低质量的x线片可能导致误诊、不必要的重复成像、辐射暴露和治疗延误。本研究旨在通过有针对性的干预来评估和提高放射学的充分性。方法本研究分析了770张膝关节、肩部和骨盆的x线片，其中376张（48.83%）来自干预前，394张（51.17%）来自干预后18个月。使用预定义的充分性评分系统，并由一名在职放射学住院医师和一名具有10年以上经验的肌肉骨骼放射学专家对干预前后的x线片进行充分性评估。干预措施包括对放射技师进行病人体位、准直和曝光设置的教学，以及在放射照相室张贴教学海报。采用p <显著性阈值对充分率和质量影响因素进行统计分析；0.05.结果干预前，64.9%（376张中244张）的干预前x线片被归类为“充分”，其余35.1%的干预前x线片被归类为“不充分”，主要原因是定位不当（79.3%）、准直不良（12.1%）或两者兼而有之（8.6%）。干预后，充分率显著提高至89.6% (353 / 394)(χ2 = 67.384, p <；0.001)。干预后组获得足够x光片的可能性大大增加，比干预前组高4.66倍。改善最明显的是膝关节外侧、肩部外旋位片和骨盆正位片。结论有针对性的教育干预可显著提高x线摄影的充分性。对实践的启示实施放射技师的教育计划可以提高成像质量，最终提高病人的护理水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.70

自引率

34.60%

发文量

169

审稿时长

63 days

期刊介绍： Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.