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An Alternative Viewing Box for Hand X-rays
Tom Reisler, BSc(Hons), MB ChB, MRCS(Ed)
Department of Plastic and Reconstructive Surgery, Guys and St Thomas Hospital NHS Trust, Lambeth Palace Road, London SE1 7EH, UK, E-mail: tomre13{at}yahoo.com
Dear Sir,
Accurate interpretation of hard-copy X-rays depends on several factors, including the consistency of spatial illumination brightness of viewing boxes (Alter et al., 1982). To maximise visual acuity, it is important that the retinal cones receive an incident luminance of 100 cd m–2 (Quality Criteria, 1990). X-ray viewing boxes of adequate quality are not always available (McCarthy and Brennan, 2003).
The author would like to suggest an alternative light projecting media for viewing X-rays, namely, the personnel computer plasma screen monitor. These are readily available and have a uniform brightness level of 200 cd m–2 across the screen. A computer screen is adequate to display small films such as hand X-rays (Fig 1).

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Fig 1 A photograph of a fifth metacarpal neck fracture X-ray placed against a monitor screen (opened against a white background of a blank Word Document page).
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References
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Alter A, Kargas GA, Kargas SA, Cameron JR, McDermott JC The influence of ambient and viewbox light upon visual detection of low contrast targets in a radiograph Investigative Radiology 1982 17 402 406.[Web of Science][Medline]
[Order article via Infotrieve]Commission of the European Communities Quality criteria for diagnostic radiographic images Working document 2 Belgium CEC, Brussels 1990 XII/173/90.McCarthy E, Brennan PC Viewing conditions for diagnostic images in three major Dublin hospitals: a comparison with WHO and CEC recommendations British Journal of Radiology 2003 76 94 97.[Abstract/Free Full Text]
Journal of Hand Surgery (European Volume), Vol. 33, No. 1,
88 (2008)
DOI: 10.1177/1753193407087123

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