The 'ABC' of examining foot radiographs

• Published in: Annals of the Royal College of Surgeons of England 2005-11, Vol.87 (6), p.449-451
• Main Authors: Pearse, Eyiyemi O, Klass, Benjamin, Bendall, Stephen P
• Format: Article
• Language: English
• Subjects: Clinical Competence; Diagnostic Errors - prevention & control; Education, Medical, Continuing - methods; Foot Injuries - diagnostic imaging; Fractures, Bone - diagnostic imaging; Humans; Injury Severity Score; Joint Dislocations - diagnostic imaging; Radiography
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588405X51119

We report a simple systematic method of assessing foot radiographs that improves diagnostic accuracy and can reduce the incidence of inappropriate management of serious forefoot and midfoot injuries, particularly the Lisfranc-type injury. Five recently appointed senior house officers (SHOs), with no casualty or Orthopaedic experience prior to their appointment, were shown a set of 10 foot radiographs and told the history and examination findings recorded in the casualty notes of each patient within 6 weeks of taking up their posts. They were informed that the radiographs might or might not demonstrate an abnormality. They were asked to make a diagnosis and decide on a management plan. The test was repeated after they were taught the 'ABC' method of evaluating foot radiographs. Diagnostic accuracy improved after SHOs were taught a systematic method of assessing foot radiographs. The proportion of correct diagnoses increased from 0.64 to 0.78 and the probability of recognising Lisfranc injuries increased from 0 to 0.6. The use of this simple method of assessing foot radiographs can reduce the incidence of inappropriate management of serious foot injuries by casualty SHOs, in particular the Lisfranc type injury.