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Purpose   X-rays are presented on CD-Rs in a digital format with increasing frequency. This technique is potentially more time-consuming for the clinician compared to conventional pictures.Methods   Ten sets of six X-rays for each case were prepared in both the conventional way and in digital format on CD-R. The order was randomised. Time in seconds was measured for six experienced orthopaedic residents to present the most recent a.p. view out of a given set. As a precondition, the computer was turned on and the same viewing software was used for all digital sets. The results were compared using a non-linked Student's t-test (significance level P = 0.05).Results   The presentation of conventional X-rays required 21 s (±7.5 s) and of digital X-rays 90 s (±27 s), respectively ( P &lt; 0.001).Conclusion   In spite of ideal conditions, digital X-rays on CD-R need significantly more time in the orthopaedic clinic. In major centres, patients present with different software and software in other languages, which increase the required time even further. This latter problem will be assessed in another study. This increase of preparation time required by a highly qualified staff member has implications on the economics and logistics and has a negative impact on daily clinical practice. One of the solutions might be that the CD-Rs be given to the registration desk and the data being already prepared when the patient sees the doctor. This can also include it being implemented in the digital system used in the inpatient part of the hospital and, therefore, making any other consultations or second opinions easily accessible.

Digital imaging data on CD-R: A time trap for orthopaedic surgeons in outpatient clinics