Accuracy of radiological diagnosis in the Casualty Department of a Children's Hospital

The radiographs of 1363 patients referred from a hospital Casualty Department were reviewed in order to study possible discrepancies between the interpretations of the films by the casualty medical staff and the radiologist. Interpretations by casualty staff were substantially correct in 96.3% of patients. Discrepancies were noted in 41 patients (3.0%)--pneumonia was overlooked on chest films in 7 cases, while 19 fractures were not noted by Casualty staff. These were almost all minor, with no problems resulting from delay in treatment. This study has implications for the training of Casualty medical staff, the cross-checking of their reports, and the possible need for Casualty department staffing by radiologists.