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X-ray interpretation in emergency department in the Kingdom of Saudi Arabia. Do we need the radiologist?

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Abstract

Introduction

Chest x-rays are widely used for diagnosing chest pathology worldwide. Pediatricians frequently interpret chest radiographs in the emergency department, guiding patient management. This study aims to assess the competency of non-radiologists in interpreting emergency chest x-rays and compare it with trainees of different levels to determine the necessity of radiologist input.

Methodology

A cross-sectional online survey was conducted in Saudi Arabia from September to October 2023, involving 385 participants, including pediatricians and medical interns from various regions. Carefully selected questions addressed a range of x-ray abnormalities in pediatric emergencies, assessing fundamental understanding of x-ray interpretation, such as inspiratory vs. expiratory and AP or PA films.

Results

The study included 385 participants, primarily Saudi nationals in the eastern region, with an equal gender distribution and ages ranging from 20 to 29 years. Approximately 29.09% demonstrated fair knowledge, with 28% being Junior Pediatrics Residents, 18% Pediatric Consultants, and 15% Senior Pediatrics Residents. Fair knowledge was significantly associated with individuals aged 20–29 years, residents of the western region, and Junior Pediatrics Residents. Clinical knowledge varied among different groups, with 59% correctly identifying atypical pneumonia and 65% recognizing asymmetrical hyperinflation. However, rates for other conditions differed, with low identification of potential foreign body aspiration and film type. Accuracy in identifying tension pneumothorax and hyperlucency varied among clinicians. Pleural effusion films had a 65% identification rate for the diagnosis, but only 28% accurately described the X-ray and selected the correct answer for lung opacity.

Conclusion

The study concluded that 29.9% of the participating physicians exhibited fair knowledge of common pediatric emergency radiological films. Junior pediatric residents showed the best knowledge, and Tetralogy of Fallot, asymmetrical hyperinflation, and pleural effusion had the highest recognition rates. In conclusion, there is still a need for radiologists in the pediatric emergency department to ensure optimal functioning.

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Abbreviations

ED:

Emergency department

EP:

Emergency physician

CXR:

Chest radiograph

CSD:

Clinically significant discrepancy

ER:

Emergency radiology

WHO:

World Health Organization

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Author information

Authors and Affiliations

  1. Radiology Department, College of Medicine, University of Hail, Hail, Saudi Arabia

    Amirah fahad alshammeri

  2. College of Medicine, King Faisal University, AlAhsa, Saudi Arabia

    Yousef A. Alhamaid, Ali Mohammad Alshakhs & Hussain Amin Algafly

  3. College of Medicine, Almaarefa University, Diriyah, Saudi Arabia

    Zinab Hasan Bohulaigah

  4. College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Ghaida Abdullah Eissa

  5. College of Medicine, University of Hail, Hail, Saudi Arabia

    Manahel Salem Almutairi

  6. College of Medicine, King Khalid University, Abha, Saudi Arabia

    Wajd Alhadi

Authors
  1. Amirah fahad alshammeri
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  2. Yousef A. Alhamaid
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  3. Ali Mohammad Alshakhs
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  4. Zinab Hasan Bohulaigah
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  6. Manahel Salem Almutairi
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  7. Wajd Alhadi
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  8. Hussain Amin Algafly
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Contributions

AM and YA conceived and designed the study and provided the research materials. MS, GA, WA and HA collected and organized the data. AM, HA, ZH, and YA analyzed and interpreted the data. AM, YA, HA, MS, AF, and GA wrote the initial and final drafts of the article and provided logistic support. All authors critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript.

Corresponding author

Correspondence to Amirah fahad alshammeri.

Ethics declarations

Ethical approval

This research was obtained from the ethical approval committee at University of Hail's (research number: UOH-REC, H-2023–358). Date:11/09/2023.

Conflicts of interest

The authors acknowledge that there are no possible conflicts of interest in the manuscript, including financial, consultant, institutional and other relationships that might lead to bias.

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In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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alshammeri, A.f., Alhamaid, Y.A., Alshakhs, A.M. et al. X-ray interpretation in emergency department in the Kingdom of Saudi Arabia. Do we need the radiologist?. Emerg Radiol 31, 203–212 (2024). https://doi.org/10.1007/s10140-024-02217-1

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