Table 3.

Changes in Clinical Care and Outcomes

CaseBody AreaClinician ReadingRadiologist ReadingChange in CareOutcome
1FootNormal2nd metatarsal stress fractureFollow-up visit scheduled*Continued pain at follow-up visit with normal radiographs 17 months later
2HandNormalNondisplaced intra-articular fracture at base of 2nd metacarpalCast applied*Continued to have pain 9 months later despite appropriate care
3Left ribs and PA chestNormalNondisplaced 5th, 6th and 7th rib fracturesNew prescription for pain medication*Pain improved at 5-week follow-up visit
4FootNormalNondisplaced 5th proximal phalangeal shaft fractureGym excuse for 3 weeks*No further follow up documented
5AnkleNormalImpacted calcaneus fractureRepeat radiographs*No calcaneal pain 9 weeks later
6HandNormalPossible fracture of DIP dorsal spurAdditional office visit repeat radiographs*Although patient free of pain or swelling, repeat radiographs were obtained.
7PA and lateral chestLung infiltrateNo acute pulmonary diseaseCancelled possible CT*Cough resolved
8Lumbar spine, AP and lateral′No acute disease′Possible spondylolysis recommended additional radiographsAdditional radiographsNo change in care for back pain
9AbdomenNormal6-mm nodule, base of lungAdditional radiographs′Nodule′ not seen on repeat radiographs
10PA and lateral chestNormalBilateral lung nodulesAdditional radiographsOne nodule was nipple, other was not identified
11PA and lateral chestNormal1-cm lung noduleAdditional radiographsNo further evaluation
12ShoulderNormalPossible mild acromioclavicular subluxation, recommended additional radiographsAdditional radiographsComplete resolution of muscular shoulder strain, no change in care of shoulder
13PA and lateral chestNormalPossible parenchymal opacityAdministrative effort to obtain old radiographs for comparisonPossible parenchymal opacity was second rib
14PA and lateral chestNormalPossible lung noduleAdministrative effort to obtain old radiographs for comparisonNodule stable for more than 2 years
15Hand§NormalFracture at base of 5th proximal phalanxNone documentedUnknown
16Thumb§NormalPossible nondisplaced Salter-Harris type II fracture of distal phalanxNone documentedUnknown
17Ankle§NormalPossible medial malleolar avulsion fractureNone documentedUnknown
18Thumb§NormalPossible nondisplaced Salter-Harris type II fracture of distal phalanxNone documentedUnknown
  • PA, posteroanterior.

  • * Presumed or documented 1 telephone contact for each case.

  • Presumed or documented 2 telephone contacts for each case.

  • Presumed or documented 3 telephone contacts for each case.

  • § No follow up documented.