title: Digitized radiographs in skeletal trauma: a performance comparison between a digital workstation and the original film images.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of a teleradiology system in skeletal trauma.
  
  
  METHODS
  Radiographs from 180 skeletal trauma patients were digitized (matrix, 2,000 x 2,500) and transmitted to a remote digital viewing console (1,200-line monitor). Four radiologists interpreted both the original film images and digital images. Each reader was asked to identify, locate, and characterize fractures and dislocations. Receiver operating characteristic curves were generated, and the results of the original and digitized film readings were compared.
  
  
  RESULTS
  All readers performed better with the original film when interpreting fractures. Although the patterns varied between readers, all had statistically significant differences (P < .01) for the two image types. There was no statistically significant difference in performance with the two images when dislocations were diagnosed.
  
  
  CONCLUSIONS
  The system tested is not a satisfactory alternative to the original radiograph for routine reading of fracture films.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Wilson
authors.forename: J C
authors.initials: JC
authors.lastname: Hodge
mesh_terms: D003195:Computer Communication Networks; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006230:Hand Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D011873:Radiology Information Systems; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology