Should all casualty radiographs be reviewed?

The effect on the management of patients of routine reporting of casualty radiographs by radiologists was reviewed. The overall prevalence of error by casualty doctors was 6.2%. Many of these errors, however, were trivial and did not alter treatment. In only 1.1% of the cases reviewed did the report of x ray films appreciably alter the management of the patient. A severity score was introduced to highlight those anatomical areas in which important lesions were overlooked most often. Radiologists' reports on radiographs of the chest, face, skull, and wrist had the greatest effect on management of patients, while reports on radiographs of fingers, hands, shoulders, long bones, and toes seldom altered treatment.