Background: Distribution of radiographic images in the outpatient setting on compact discs-recordable (CD-R) is
commonplace. Opening, manipulating and interpreting these can be challenging. This study evaluated the availability
and ease of use of CD-R to evaluate digital images in an outpatient orthopedic setting.
Methods: 118 CD-R containing diagnostic studies were evaluated by seven board certified orthopaedic surgeons.
Surgeon age and self-perceived “tech savvy” scores were tabulated using a visual analog scale (VAS). Surgeons
evaluated: ability and number of computers to open, autorun, and specific reader software. Time to load was recorded
in seconds, type of study, presence of “not for diagnostic use”, and if the disc required additional software. Studies were
graded using a VAS for ease of opening, ability to move from image to image and/or between series, to manipulate
the image, and to zoom and pan.
Results: There were 79 radiographs, 29 MRI’s, and 10 CT scans. Seven (6%) had to be manually opened and
four (3%) required software installation. Thirteen (11%) contained a warning that the studies should not be used for
diagnostic purposes. Six (5%) of the studies could not be opened. For the opened studies, average time from disk
insertion to image was 43.7 seconds overall (range 3-350), 65.3 seconds (range 21-191) for MRI and CT, and 35.2
seconds (range 5-177) for radiographs.
Conclusion: The present digital imaging systems include different software types and a variety of interfaces.
Improving this would decrease time and effort necessary to open and evaluate these studies, and improve
Level of evidence: III