Subtle orthopedic fractures: Teleradiology workstation versus film interpretation

William W. Scott, Jessica E. Rosenbaum, Stacey J. Ackerman, Ralph L. Reichle, Donna Magid, Jeffrey C. Weller, Joseph N. Gitlin

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


The purpose of this study was to evaluate whether radiologists perform equally well with plain radiographs or digitized images displayed on a video monitor in interpretation of difficult orthopedic trauma cases. Interpretations with film and those made from a teleradiology system with spatial resolution of 2.35 line pairs per millimeter were compared in 120 difficult cases, 60 with the selected abnormality (ie, fracture or dislocation) and 60 that were control cases. Seven senior radiology residents and one radiology fellow each interpreted 60 randomly ordered cases with the teleradiology system (1,280 × 1,024-pixel monitors) and 60 cases with the original radiographs. The overall accuracy of the readers was 80.6% for film interpretations and 59.6% for teleradiology screen readings (P < .001). Sensitivity was 78.5% for film and 48.8% for on-screen images (P < .001), and specificity was 83.2% for film and 72.3% for on-screen images (P < .025). Receiver operating characteristic analysis showed rejection of the null hypothesis in favor of film interpretation (P < .0049). It was concluded that the teleradiology system was not acceptI able for primary diagnostic interpretation of difficult fracture cases.

Original languageEnglish (US)
Pages (from-to)811-815
Number of pages5
Issue number3
StatePublished - Jun 1993


  • Diagnostic radiology, observer performance, 40.11, 40.1215, 40.41
  • Fractures, 40.41
  • Images, interpretation, 40.11, 40.1215
  • Receiver operating characteristic curve (ROC)
  • Video systems

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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