Which side is which? [QSI Ref: XR-503]

Radiographic image labelling.

Radiographic images must carry unambiguous side markers. Markers should be placed pre-imaging as there is a risk of error if they are applied as part of post processing procedures.

The standard: 

• A locally agreed standard

• All images should contain a legible anatomical side marker

• The marker should have been placed prior to the exposure

Target: 

Indicators: 

• % of images which have side marker

• % of images where marker is in primary beam and was placed pre-exposure

• % of images where marker was placed at time of post processing, but pre-exposure marker is visible in secondary beam

• % of images where marker only placed at post processing stage

Data items to be collected: 

• For each image record if the side marker is present and legible

• Type of marker present - ie pre or post-processing and whether for pre-processing ones it is in primary or secondary beam

Suggested number: 

• Identify the failures and the reasons for failures

• Discuss the results at radiographer audit meetings

• Some appropriate changes might include:

   - Training on correct use of PACS, using radiographer identifiable clip on markers

   - Reminder notices on the X-ray units

If there are persistent issues it may be worth looking to see if there are marked differences between different members of staff and issuing individual results in anonymised manner so individuals can compare their results with those of their peers.

1. Jenkins, D. Radiographic Photography & Imaging Processes. Lancaster: MTP, 1986:157. 

2. Chesney DN, Chesney MO. Radiographic Photography. Oxford: Blackwell, 1971:308–309.

Taken from Clinical Audit in Radiology 100+ recipes RCR 1996, updated by CRAQIC