Opinion

Avoiding the pitfalls of X-ray interpretation

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I have written an article in Emergency Nurse that deals with the accessory bones and ossicles of the foot and ankle. This article came about through my interest in general orthopaedics and X-ray interpretation, which can be a big part of the nurse practitioner role in an emergency department.

Foot X-ray

With experience, X-ray interpretation can be a skill in which nurse practitioners can become very competent. Still, there are sometimes images that catch out even the most experienced practitioner.

That’s why I decided to write an article that helps to demystify some of the rare but normal abnormalities that can be apparent on an X-ray of a foot or ankle. Some the abnormalities I highlight wouldn’t be seen on a regular basis; others are more common.

Having even a little knowledge about these abnormalities can be valuable when it comes to providing care, and knowing the difference between these normal abnormalities and identifying a fracture can elevate the nurse practitioner from being a competent practitioner to an expert one.

This knowledge can also save a lot of inconvenience to patients as well. It means that they aren’t placed unnecessarily in casts, which restrict daily activities and may cause loss of income and many other hardships. It also means that potential fractures are not be identified incorrectly as normal abnormalities. 

There is an onus on nurse practitioners to be confident in their practice. If there is any doubt that harm may be done to patients by failing to identify fractures or identifying normal abnormalities incorrectly, my advice is to treat clinically; it is better to over-treat patients and inconvenience a little rather to allow the larger inconvenience of missing a significant injury.

About the author

Anthony Summers is a nurse practitioner at Redlands Hospital emergency department, Cleveland, Queensland, Australia

Read the article

Accessory ossicles and sesamoid bones: recognition and treatment

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