An audit to evaluate the quality of plain film mortise radiographs of the ankle joint in the ED against the recognised gold standard
Ankle injuries are one of the most prevalent musculoskeletal injuries presenting at A&E and correct identification is crucial due to the complex fragility of the joint. Plain film x-ray remains a primary diagnostic option for patients presenting with ankle trauma, with the mortise view being predominantly used, as the fibular fossa is clearly visible with minimal tibiofibular overlap, allowing for accurate assessment of the syndesmosis joint. Accurate patient positioning enables a more definitive diagnosis.
The gold standard for the mortise projection set by the RCR6 ensures that accurate views of the mortise joint and clear definition of bony detail can be obtained. Radiographs that do not meet this gold standard inevitably lead to insufficient clinical diagnosis, and suboptimal levels of diagnostic quality expose the patient to extra radiation doses due to an increased number of repeat projections required.7,8 Ultimately, when the gold standard is consistently attained, the best evidence-based practice (EBP) is delivered, enhancing patient care.
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