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Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections
Snaith, Beverly ; Raine, S. ; Fowler, L. ; Osborne, C. ; House, S. ; Holmes, R. ; Tattersall, E. ; Pierce, E. ; Dobson, M. ; Harcus, James
Snaith, Beverly
Raine, S.
Fowler, L.
Osborne, C.
House, S.
Holmes, R.
Tattersall, E.
Pierce, E.
Dobson, M.
Harcus, James
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Publication Date
2020-09-01
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(c) 2020 The Authors.
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openAccess
Accepted for publication
2020-05-27
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Abstract
In relation to wrist imaging, the accepted requirement is two orthogonal projections obtained at 90°, each with the wrist in neutral position. However, the literature and anecdotal experience suggests that this principle is not universally applied. Method: This multiphase study was undertaken across eight different hospitals sites. Compliance with standard UK technique was confirmed if there was a change in ulna orientation between the dorsi-palmar (DP) and lateral wrist projections. A baseline evaluation for three days was randomly identified from the preceding three months. An educational intervention was implemented using a poster to demonstrate standard positioning. To measure the impact of the intervention, further evaluation took place at two weeks (early) and three months (late). Results: Across the study phases, only a minority of radiographs demonstrated compliance with the standard technique, with an identical anatomical appearance of the distal ulna across the projections. Initial compliance was 16.8% (n = 40/238), and this improved to 47.8% (n = 77/161) post-intervention, but declined to 32.8% (n = 41/125) within three months. The presence of pathology appeared to influence practice, with a greater proportion of those with an abnormal radiographic examination demonstrating a change in ulna appearances in the baseline cohort (p
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Accepted manuscript
Citation
Snaith B, Raine S, Fowler L et al (2020) Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections. Hand Therapy. 25(3): 107-113.
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Article