Since Codman, x-ray film has provided the basis for the determination of much of orthopaedic practice and research. From x-ray data, descriptions of injury severity and treatment outcome are derived. The requisite archival procedures and expense, however, many times limit the availability of this data for clinical and research analysis.

Several studies (1,2,3,4,5) in the radiographic literature have established that digital images provide a diagnostic quality comparable to conventional x-ray film.

This study by Douglas Lundy of the Department of Orthopaedics at Vanderbilt University Medical Center seeks to answer the question:

Can digitized x-ray images of diagnostic quality (a resolution sufficient for accurate diagnosis by orthopaedic traumatologists) be routinely collected by low cost commercially available equipment and uncomplicated, rapid procedures?

• This internet web site exhibits 22 AP hip and pelvic images. The study is divided into 2 parts with 11 AP hip and pelvic images in each part.
• Each observer should view all the images and answer the questions accompanying each image.
• After completing the questions, each observer should click "submit", which will send the observer’s answers as an email message to Douglas Lundy, MD (dwlundy@pol.net).

• This study requires version 4.0 or later of either NetScape Navigator or Internet Explorer.
• Through "Preferences" in Netscape or "Options" in Internet Explorer, both Java and JavaScript must be turned on.
• For optimal image viewing, the display/monitor control panel should be set at a minimum of "16 bit" or "thousands" or "high color".
• The study web pages contains smaller 11 images. A high speed connection (T3, T1, cable modem, ADSL, ISDN) is recommended. If the internet connection is a 28.8 kbps modem, allow for a download time of up to 30 seconds.

THANK YOU FOR YOUR PARTICIPATION IN THIS STUDY! Please feel free to send comment related to this study to Douglas Lundy, MD (dwlundy@pol.net). If you are encountering technical difficulties performing this study, contact William D. Burman, MD (wdburman@frontiernet.net).

1) Richmond BJ, Powers C, Piraino DW, Freed H, Meziane MA, Hale JC, Schluchter MD, Schils J, Gragg LA; Diagnostic efficacy of digitized images vs plain films: a study of the joints of the fingers.; AJR Am J Roentgenol 1992 Feb;158(2):437-41

2) Sheline ME, Brikman I, Epstein DM, Mezrich JL, Kundel HL, Arenson RL; The diagnosis of pulmonary nodules: comparison between standard and inverse digitized images and conventional chest radiographs; AJR Am J Roentgenol 1989 Feb;152(2):261-3

3) Murphey MD, Digital skeletal radiography: spatial resolution requirements for detection of subperiosteal resorption.;AJR Am J Roentgenol 1989 Mar;152(3):541-6

4) Elam EA, Rehm K, Hillman BJ, Maloney K, Fajardo LL, McNeill K; Efficacy of digital radiography for the detection of pneumothorax: comparison with conventional chest radiography; AJR Am J Roentgenol 1992 Mar;158(3):509-14

5) Buckwalter KA, Braunstein EM; Digital skeletal radiography.;AJR Am J Roentgenol 1992 May;158(5):1071-80