Adequacy of lateral knee radiographs performed for trauma
Descriptor
An audit of the performance of knee radiographs in trauma, looking specifically at congruity of the lateral and medial femoral condyles as well as, under or over-exposure.
Background
Conspicuity of joint effusions and lipohaemarthroses are optimised by adequately exposed true lateral knee radiographs.
The Cycle
The standard:
All horizontal beam lateral knee radiographs for trauma should have:
1) Adequate exposure
2) Medial and lateral femoral condyles congruous within 7mm
Target:
95% compliance with both standards.
Assess local practice
Indicators:
Proportion of trauma knee radiographs deemed adequate by the above two criteria.
Data items to be collected:
For each knee x-rayed, document whether:
1) Exposure adequate
2) Femoral condyles congruous within 7mm
Suggested number:
Typical numbers of knees examined: 20 depending on A+E throughput.
Suggestions for change if target not met
• Education of (and by) experienced radiographer and radiologists
• Reading reference given
Resources
- Questionnaire
- Excel or similar spreadsheet to tabulate responses and analyse statistics
- Five hours work
References
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Fuller MJ Lateral Knee Radiography - http://www.wikiradiography.net/page/Lateral_Knee_Radiography
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The WikiRadiography forms a particularly rich web resource.http://www.wikiradiography.net/page/Applied_Radiography_-_by_M.J.Fuller
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Merrill's Atlas of Radiographic Positions and Radiologic Procedures, (Editor: Philip W. Ballinger) 10th Edition (2003).
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Tai AW et al Accuracy of Cross-Table Lateral Knee Radiography for Evaluation of Joint Effusions AJR 2009; 193:W339- W344 http://www.ajronline.org/content/193/4/w339.full.pdf+html
Submitted by
Dr D Tennant. Updated by A Marzoug