title: Evidence-based practice in the utilization of knee radiographs--a survey of all members of the British Orthopaedic Association.
abstract: There has been a debate amongst orthopaedic surgeons about which plain radiographs are required in common knee conditions and this is a 5-year review assessing the influence of recent publications on the use of radiographs. A postal survey of all members of the British Orthopaedic Association was performed. The response rate was 60% (990/1,650). There was a broad agreement on the use of anteroposterior and lateral radiographs. The use of the posteroanterior (PA) weight-bearing radiograph has increased from 82 to 86%. The use of skyline view for suspected arthritis and after knee replacement has increased from 23 to 41%. There is still disparity amongst orthopaedic surgeons regarding the knee flexion angle for skyline and weight-bearing views. After review of the literature we recommend that a single skyline view in 30 degrees flexion is adequate and should be a standard investigation in knee disorders. We also stress the importance of weight-bearing PA radiograph in 30 degrees knee flexion for adequate assessment in all patients with suspected arthritis.
authors.affiliation: Norfollk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK. sharad_bhatnagar@rediffmail.com
authors.forename: S
authors.initials: S
authors.lastname: Bhatnagar
authors.forename: R
authors.initials: R
authors.lastname: Carey-Smith
authors.forename: C
authors.initials: C
authors.lastname: Darrah
authors.forename: P
authors.initials: P
authors.lastname: Bhatnagar
authors.forename: M M
authors.initials: MM
authors.lastname: Glasgow
mesh_terms: D001175:Arthrography / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D019538:Health Care Surveys; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D009985:Orthopedics; D010820:Physicians; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D006113:United Kingdom