Clinico-radiologic correlates of oral and maxillofacial radiographs: A 3-year study of 156 patients in a Nigerian teaching hospital

Background: Any discrepancy between clinical and radiographic information may have dire consequences on the optimal care of patients. Aim: The aim of this study was to determine the correlation between the clinical and radiographic findings in oral and maxillofacial surgery patients. Materials and Methods: This was a retrospective study of all patients with plain radiographic views of the oral and maxillofacial region, seen at a Nigerian Teaching Hospital, over a 3-year study period. The radiographs and patients' case files were retrieved and demographic, clinical as well as radiographic information were obtained. Radiographic information obtained included source and types of the radiographs, patients' bio-data, side and site of the pathology, clinical indication, labeling on the radiograph as well as interpretation errors in form of missed diagnosis other than missed fractures. The data were analyzed using SPSS version 13. Cohen's kappa agreement test was done between clinical and radiographic information.P <0.05 was considered significant. Results: Radiographs from 156 patients aged 8–80 years, mean (standard deviation), 37.9 (19.22) years, were reviewed. There were 102 males and 54 females. Trauma (n = 54; 34.6%) was the most common indication for radiographs. “Transposition” of side of the lesions accounted for 9 (5.8%) of the cases. Radiographic “transposition” was significantly associated with facial fractures, temporomandibular joint ankylosis, and impacted mandibular third molars (likelihood ratio: χ2 = 16.930; df = 10;P = 0.03). There was some disagreement between clinical and radiographic information with regard to side (kappa = 0.788;P = 0.001). Conclusion: Discrepancies in the side of lesions, between clinical and radiographic information, were observed in this study. Adequate care should be taken by clinicians and radiologists to minimize errors in radiographs.