Radiographer abnormality detection system

Last revised by Dr Ian Bickle on 26 Apr 2020

The radiographer abnormality detection system, otherwise known as the red dot system, is a system that was first trialled during 1981 in London, United Kingdom at the Ealing Hospital, and soon after at Northwick Park Hospital. The results of the trial were reported in 1985 1. Radiographers communicated to the referrer that an image potentially contained an abnormality via affixing a small red circular sticker (therefore a "red dot") to a radiograph. This system saw radiographers playing a more meaningful part in emergency departments 1.

Radiographers attend one-day red dot courses to gain competency before they are allowed to "red dot" radiographs. 

Since the advent of digital radiography often departments will still digitally affix the word 'red dot' as a homage to the traditional system.


One of the key benefits of this system is an increased level of communication between the radiography team and the referring team within a hospital environment. Images with a red dot sought greater scrutiny from the referring clinicians and overall reduced errors in the emergency department 1.


Radiographer abnormality detection systems did not specify what potential abnormality the radiographer is flagging, posing a considerable degree of ambiguity 3. It is due to this, particularly in the United Kingdom that radiographer abnormality detection systems have evolved to incorporate radiographer commenting. Contrary to popular belief commenting is not a considered a diagnostic report, nor does it strive to replace one, rather, a short note accompanying the flagged specifying the potential abnormality 2.

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: distal radius fracture with triquetral avulsion
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  • Case 4: triquetral fracture
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  • Case 5: zygomatic arch fracture
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  • Case 6: fractured radius
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  • Case 7: lateral knee dislocation
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  • Case 8: cuboid fracture
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  • Case 9: distal femoral periprosthetic fracture
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  • Case 10: pneumothorax
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