Notes on radiographic quality and view type

Radiograph quality

One of the most common reasons for rejecting a referral is when, where requested, uploaded radiographs are either:

• Of non-diagnostic quality (either due to source image or scanning artefacts)
• Of the wrong image or view type

It is therefore important to remember that the referring GDP should ensure that the document/s or radiograph/s to be uploaded are of sufficient quality prior to uploading into the patient’s referral.

Common issues with radiographs

Depending on the nature of the referral and the area you work in, your referral may require a radiograph to be uploaded. Where clinical triage systems are in place, the triagers will normally reject radiographs that are not appropriate and hence this will delay your patient’s referral.

No radiographs

This is the most common reason for the rejection of a referral. Please ensure that you have read the referral guidance notes to see if a radiograph is required and of what type. If you cannot provide a radiograph please provide sufficient justification for this.

Non diagnostic quality

Another common reason to reject a referral is for non-diagnostic value. For example this radiograph would be of little value in assessing the periapical status of the imaged teeth and it is therefore likely to be rejected on this basis.

Wrong image type

The most frequent reason for this rejection is the provision of intra-oral radiography rather than extra-oral; especially when considering third molars. Please refer to the guidance notes for your area regarding understanding the nature of DPT provision. If a local hospital holds the necessary imaging, please make an IEP request for this using the IEP request form. You can also state on the referral which hospital holds any imaging and the referral centre can make the request - Please note we need to know the specific hospital to do this.

Compression and cropping

It should not be necessary to compress any images before uploading.  Compression can impact on the diagnostic quality of images and hence your should upload the original image.  Images should also not be cropped as this may also remove diagnostically valuable information.  A full and true representation of the image should be provided. Please note you may need to reduce the file size (not compress, reduce), to send the referral. Many providers, including hospitals, still receive via NHS mail and all email has a restriction on permitted attachment size

Other materials

Other documents may be uploaded to the system – such as letters or reports – please ensure that these are scanned at high quality and are orientated correctly. PDF is the best format for these attachments as TIFF files tend to be very large and may exceed the maximum permitted.