Are orthopaedic surgeons reading radiology reports? A Trans‐Tasman Survey

Krüger, Paul; Lynskey, Samuel; Sutherland, Alasdair

doi:10.1111/1754-9485.12871

Cited by 8 publications

(16 citation statements)

References 13 publications

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“…Finally, the MRI report is very seldomly reviewed in isolation (0.3–3%). This is similar to the described survey results by Kruger et al on orthopaedic surgeons reading radiology reports in addition to viewing images for any imaging modality [ 20 ].…”

Section: Discussionsupporting

confidence: 89%

Utilization of MRI in surgical decision making in the shoulder

Simon

Regan

2022

BMC Musculoskelet Disord

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Background The aim of this study is to evaluate both the utility of MRI scans and reports used in the current practice routine of shoulder surgeons and their surgical decision-making process. Methods Ninety-three shoulder-specialised orthopaedic surgeons of the Canadian Shoulder and Elbow Society (CSES) Orthopaedic Association were surveyed in 2020 anonymously online to help identify the use of MR-imaging and reports in managing shoulder disorders and surgical decision process. Results Thirty out of 93 (32.25%) CSES fellowship-trained orthopaedic surgeons participated. Respondents request MRI scans in about 55% of rotator cuff (RC) pathology and 48% of shoulder instability cases. Fifty percent of patients with potential RC pathology arrive with a completed MRI scan prior first orthopaedic consult. Their surgical decision is primarily based on patient history (45–55%) and physical examination (23–42%) followed by MRI scan review (2.6–18%), reading MRI reports (0–1.6%) or viewing other imaging (3–23%) depending on the shoulder disease. Ninety percent of surgeons would not decide on surgery in ambiguous cases unless the MR-images were personally reviewed. Respondents stated that shoulder MRI scans are ordered too frequently prior specialist visit as identified in more than 50% of cases depending on pathology. Conclusions The decision-making process for shoulder surgery depends on the underlying pathology and patient history. The results demonstrate that orthopaedic surgeons are comfortable reviewing shoulder MRI scans without necessarily reading the MRI report prior to a surgical decision. MRI scans are becoming an increasingly important part of surgical management in shoulder pathologies but should not be used without assessment of patient history and or physical examination.

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Section: Discussionsupporting

confidence: 89%

Utilization of MRI in surgical decision making in the shoulder

Simon

Regan

2022

BMC Musculoskelet Disord

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“…Studies showed no significant diagnostic difference between orthopaedists and radiologists [6,7] or superiority of the orthopaedist's assessment [8,9]. Conversely, in an earlier survey among 200 Australian and New Zealander orthopaedists, only 10% voted to consult X-ray reports [2]. In contrast, 43% of all participants and 35% of board-certified surgeons in our study voted to routinely consult radiograph reports.…”

Section: Discussioncontrasting

confidence: 81%

“…Accordingly, the majority of recommendations for radiology service improvement addressed the time issue as well, suggesting faster report turn-around times and shorter texts for improved reporting practice. Similarly, 63.5% among the Australian and New Zealander orthopaedists answered that radiograph reports were only sometimes available for consultation, highlighting the same issue [2]. The presented survey results revealed a desire towards an increased use of classification systems and angle measurements in radiology reports, which may contradict the call for shorter documents.…”

Section: Discussionmentioning

confidence: 85%

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Orthopaedic surgeons do not consult radiology reports. Fact or fiction?

Donners

Gutzeit

Gehweiler

et al. 2021

European Journal of Radiology

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To find out how orthopaedic surgeons handle radiological reports and to identify ways to improve musculoskeletal radiology service and interdisciplinary communication.Method: An anonymised 14-question online survey was distributed among 27 orthopaedic departments in German-speaking parts of Europe. It was available to trainees and consultants between 22/10/2020 and 05/06/ 2021. The questionnaire collected information regarding the participants' habits of consulting radiology reports depending on the imaging modality, reasons for not reading reports and asked for improvement recommendations for the radiology service. Results: 81 orthopaedists participated. 20% would never consult a plain radiograph report. In contrast, only 4% would never consult a CT report and no one claimed to never consult an MRI report. 43%, 67% and 86% would routinely consult radiology reports of radiographs, CT and MRI studies, respectively. Long time to report availability (24%), a general lack of time (19%) and too long texts (17%) were the most popular reasons for not consulting the reports. 62% of participants voted to sometimes disagree with the reports and in cases of opinion discrepancy 51% would always or often contact the radiologist. 64% preferred to be informed directly via phone about relevant unexpected findings. Most popular report improvement recommendations were more rapid report availability (24%), inclusion of significant images (19%) and inclusion of more angle and distance measurements (16%). In the free text column, a desire for direct interdisciplinary discussion of equivocal cases was often stated (30%). Conclusions: Concluding, this survey showed that orthopaedic surgeons routinely consult radiology reports. The participants expressed a desire for increased, direct interdisciplinary communication to solve equivocal cases and improve patient care.

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“…This was a standardized method that could be reliably reproduced from each patient’s record; however, it did not account for the surgeon’s interpretation of the imaging, which can often differ from the radiologist report, or the surgeon may not be routinely reading the report. 20 , 21 Thus, there is the possibility that the critical differences observed, as well as the critical changes in treatments performed, may be different depending on surgeon interpretation and/or experience. Second, in this patient cohort, we did not account for the number of instability episodes as it pertains to the MRI or arthroscopic findings.…”

Section: Discussionmentioning

confidence: 99%

Shoulder Arthroscopy in Conjunction With an Open Latarjet Procedure Can Identify Pathology That May Not Be Accounted for With Magnetic Resonance Imaging

Ernat

Rakowski

Casp

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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To review arthroscopic findings at the time of open Latarjet procedures to determine whether preoperative magnetic resonance imaging reports (MRRs) correlate with arthroscopic findings, as well as whether the arthroscopic findings critically affected surgical interventions performed at the time of a Latarjet procedure. Methods: This was a retrospective case series of all patients who received a Latarjet procedure between 2006 and 2018. Patients were excluded if they had inadequate records or underwent revision of a bony reconstruction procedure. Both primary Latarjet procedures and Latarjet procedures for revision of a failed arthroscopic procedure were included. MRRs, arthroscopic findings, and diagnoses were collected, and differences were noted. A "critical difference" was one that affected the surgical intervention in a significantly anatomic or procedural fashion or that affected rehabilitation. Results: In total, 154 of 186 patients (83%) were included. Of these, 96 of 154 (62%) underwent revision Latarjet procedures. The average bone loss percentage reported was 20.6% (range, 0%-40%). A critical difference between MRR and arthroscopic findings was noted in 60 of 154 patients (39%), with no difference between Latarjet procedures and revision Latarjet procedures. Of 154 patients, 29 (19%) received an additional 52 intra-articular procedures for diagnoses not made on magnetic resonance imaging, with no difference between primary and revision procedures. This included biceps and/or SLAP pathology requiring a tenodesis, debridement, or repair; rotator cuff pathology requiring debridement or repair; complex (>180 ) labral tears requiring repair; loose bodies; and chondral damage requiring debridement or microfracture. Patients undergoing revision Latarjet procedures were less likely to have bone loss mentioned or quantified in the MRR. Conclusions: Diagnostic imaging may not reliably correlate with diagnostic arthroscopic findings at the time of a Latarjet procedure from both a bony perspective and a soft-tissue perspective. In this series, diagnostic arthroscopy affected the surgical plan in addition to the Latarjet

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Are orthopaedic surgeons reading radiology reports? A Trans‐Tasman Survey

Cited by 8 publications

References 13 publications

Utilization of MRI in surgical decision making in the shoulder

Utilization of MRI in surgical decision making in the shoulder

Orthopaedic surgeons do not consult radiology reports. Fact or fiction?

Shoulder Arthroscopy in Conjunction With an Open Latarjet Procedure Can Identify Pathology That May Not Be Accounted for With Magnetic Resonance Imaging

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