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Abstract Introduction This study illustrates image rejection rates of the lateral wrist x‐ray projection at a large, public teaching hospital. Rejected images were evaluated to determine the number of images that needed to be repeated based on the clinical indication. This study highlights the difference in subjective image‐repeat decision‐making skills existing between radiologists, experienced radiographers and junior radiographers. Methods A retrospective review was conducted of all rejected lateral wrist x‐ray images by a panel of three radiologists, three experienced radiographers and six junior radiographers. This review aimed to determine if rejected imaging met the consideration of the clinical indication and assumed appropriate acquisition of an orthogonal projection. A complement of images that had not been rejected were included in the review to create a blinded study. Results The review demonstrated 85.8% of rejected images were deemed to meet clinical requirements according to radiologists. The experienced radiographers agreed with radiologists regarding 75.3% of images. Junior radiographers agreed with radiologists in 34.2% of cases. Junior radiographers were three times more likely to seek repeat imaging than the radiologists and experienced radiographers. Conclusions This review demonstrated a lateral wrist projection reject rate of 38.7% with unnecessary repeats according to clinical indications in 85.8% of cases. The review of experienced radiographers was comparable to radiologists; however, the difference in decision‐making skills was evident in the junior radiographers. This highlights an alarming trend, should similar results be demonstrated at other health services and indicates an unnecessary burden to clinical practice. Inclusion of clinical reasoning for imaging and the need for repeat imaging is recommended for radiography training programs.

Abstract Background: Radiography is the most widely available imaging modality. Precise evaluations of wrist x-ray can help diagnosis and evaluate the prognosis of many wrist disorders. Methods: We measured length, angles and indices in 150 posteroanterior and lateral wrist x-rays to determine normal dimensions and variations according to age and sex. All x-rays were made with standard exposure, with the wrist and forearm in a neutral position. Results: The average carpal height ratio was 0.52±0.03 with the Youm method and 1.5±0.09 with the Nattrass method. Mean ulnar variance was +0.99±1.6 mm and mean radial inclination was 25±4 degrees. The average radial tilt was 10±5.1 degrees. Mean scapholunate angle was 50±8.4 degrees (normal range 40 -60). Conclusion: Carpal height, third metacarpal and capitate length were smaller in women than in men. There was a significant positive relationship between all dimensions. Our data base may be used to follow-up in conditions such as carpal instability, osteoarthritis and osteonecrosis, as well as for clinical research.

Background: The measurement of hand grip strength has several clinical applications to evaluate chronic hand disability, response to treatment, and work capacity after hand injury. Methods: We measured hand grip strength of 41 adults and compared their maximum strength with radiographic indices. Results: There was a significant relationship between hand grip strength and carpal height, third metacarpal and capitate length (All p-values