CLINICAL RESEARCH
Access
to Musculoskeletal Imaging Studies in Argentina: Are Orthopaedic Surgeons Mere Bystanders?
Daniel
Moya,* José L. Osma Rueda,** Santiago Focaraccio,#
Juan Carlos Uribe
Caputi,## Santiago Ávila Posada,* Miguel Ángel Flores Ruiz,§
Federico Alfano,§§
Diego Gómez*
*Orthopedics and Traumatology Service,
Hospital Británico de Buenos Aires,
Autonomous City of Buenos Aires,
Argentina
**Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
#Centro Médico
San Lucas, Gualeguaychú, Entre Ríos, Argentina
##Grupo de Investigación Observatorio de Salud Pública
de Santander, Universidad Autónoma de Bucaramanga, Santander, Colombia
§Orthopedic Surgery
and Traumatology Service,
Hospital Universitario Puerta
del Mar, Cádiz,
Spain
§§Orthopedic Surgery
Department, Clínica Universidad de Navarra, Pamplona,
Spain
ABSTRACT
Introduction: Access to
imaging study results has undergone substantial changes in recent years,
affecting the practice of orthopaedic surgeons. Objective: To
evaluate the perceptions of orthopaedic surgeons in Argentina regarding access to imaging
studies, image quality, and the impact of these factors
on clinical practice.
Materials and Methods: A total of 323 members of the
Argentine Association of Orthopaedics and Traumatology participated in the survey. Data
were analyzed according to years in practice, geographic region,
workplace, and subspecialty. Results: A significant change in access
to imaging studies was observed, with 62% of respondents reporting
a substantial impact.
Nearly 50% reported
being dissatisfied with current access methods, and 47% indicated that access difficulties
frequently or very frequently had a negative impact on their clinical practice. According to 29% of respondents, attempts
to access imaging
studies took up as much as 40–50%
of the consultation time. Ninety-two percent had received no formal training
in the use of the new digital
platforms. Perceptions of image quality
varied, with 24% considering
it worse than in their previous experience. Conclusions: Orthopaedic surgeons in Argentina
report high levels of dissatisfaction and frequent difficulties accessing imaging studies.
A lack of training and insufficient consideration of physicians as primary users contribute to this perception. This study highlights the need to involve healthcare professionals as key stakeholders in the design and implementation of imaging
access systems.
Keywords: Digital imaging; orthopaedics and traumatology; outpatient imaging;
diagnostic imaging; surveys;
questionnaires.
Level of Evidence: IV
Acceso a estudios por imágenes musculoesqueléticas en la Argentina: ¿somos los ortopedistas convidados de piedra?
RESUMEN
Introducción: El acceso a los resultados de estudios por imágenes ha experimentado cambios sustanciales en los últimos años que influyen en la práctica del especialista en ortopedia y traumatología. Objetivo: Evaluar la percepción de los especialistas en
ortopedia y traumatología de la Argentina sobre
el acceso a estudios por imágenes,
su calidad y el efecto en la práctica clínica. Materiales y
Métodos: Participaron de la encuesta 323 miembros de la Asociación Argentina de Ortopedia
y Traumatología. Los datos se analizaron según los años de ejercicio, la región geográfica, el lugar de trabajo y la subespecialidad. Resultados: Se
observó un cambio significativo en el acceso a estudios por imágenes, el 62% reportó un impacto importante. Casi el 50% informó estar insatisfecho con los métodos actuales de acceso y el 47%, un impacto negativo frecuente o muy frecuente en su práctica clínica. Según el 29%, los intentos de acceso consumieron hasta el 40-50%
del tiempo de consulta. El 92% no recibió capacitación formal en las nuevas plataformas digitales. La percepción de la calidad de las imágenes fue variable:
el 24% las consideró peores que en experiencias previas.
Conclusiones: Los especialistas argentinos en ortopedia y traumatología reportan altos niveles de insatisfacción y dificultades frecuentes en el acceso a estudios por imágenes. La falta de capacitación y la escasa consideración de los médicos como usuarios primarios
contribuyen a esta percepción. Este estudio resalta la necesidad de involucrar a los profesionales como actores clave en el diseño e implementación de sistemas de acceso a imágenes.
Palabras clave: Imágenes digitales; ortopedia y traumatología; imágenes ambulatorias; diagnóstico por imágenes; encuestas;
cuestionarios.
Nivel de Evidencia: IV
INTRODUCTION
Imaging
studies play a fundamental role in the diagnosis,
staging, therapeutic decision-making, preoperative planning, and monitoring of
musculoskeletal conditions.1,2
Difficulties and limitations in accessing the information provided
by diagnostic imaging
studies can have a significant negative impact on orthopedic
and trauma practice.3
In
recent years, in our practice as orthopedic and trauma specialists, we have
observed substantial and rapid changes in the ways imaging results are
accessed.4,5 Traditional radiographic films have progressively
given way to formats including laser-printed images, compact
discs, institutional Picture
Archiving and Communication Systems (PACS), and digital platforms accessible from computers
and mobile devices. Although these tools were designed to facilitate and
streamline access to imaging studies, their implementation has not always met
initial expectations.5,6 In practice, the traditional, straightforward
availability of printed studies has been replaced by difficulties associated
with digital access, such as connectivity issues, technological
incompatibilities, and the proliferation of online platforms. Furthermore, even when the images can be accessed,
they are often accompanied
by warnings stating that they are not suitable for diagnostic purposes (Figure 1), despite obviously having been requested
for that purpose.
It should
be noted that orthopedic and trauma specialists have had limited,
if any, involvement in the implementation of these changes and have
been forced to adapt to them in their daily practice, regardless of whether
they agreed with them. In most cases, these changes have been implemented
without prior consultation and presented as a fait accompli.
The
objective of this study was to evaluate the perceptions of orthopedic and
trauma specialists in Argentina regarding the current process of accessing
requested diagnostic images and the quality of those images.
MATERIALS AND METHODS
A semistructured survey was designed
based on previous
studies7-9 and adapted
to the local practice setting.
Two of the authors
developed the questions independently. Subsequently, two other authors
conducted a pilot
test to optimize
the instrument. Consensus-based modifications were then made, resulting
in the final version of the survey.
The final
questionnaire included 15 questions divided
into three sections
(Table 1).
The
first section, consisting of four questions, was designed to collect
participants’ demographic data. Participants were asked to indicate their
primary practice setting (public institution, private institution, or private
practice). If they worked in more than one setting,
they were instructed to select only the setting
on which they would
base their responses.
The
second section included 10 questions designed to assess participants’
perceptions of the new methods of accessing images and their impact on clinical
practice.
Finally,
participants were asked whether they had received any type of training from imaging service
providers or from the institutions where they reported working.
The
questions were uploaded to the SurveyMonkey® platform. The survey received
prior approval from the Executive Committee of the Argentine Association of Orthopedics and Traumatology and was announced
to its members via email and social media (Figure
2).
The researchers adhered to best practices for the responsible use of data (European General
Data Protection Regulation). Responses were anonymous, and no personal
data were collected
from any participant. Only the principal investigator had access to the
platform. Data from the responses were to be used solely for publication
purposes. Once submitted, responses could not be edited. Each respondent could
complete the survey only once, and all questions had to be answered for the
response to be considered valid and included in the final analysis.
Where
appropriate, ordinal data were analyzed using values ranging from 1 to 5.
Open-ended responses were coded independently by two researchers, and consensus
was reached for the qualitative analysis.
Statistical Analysis
The
results for all questions were evaluated using Cronbach’s alpha coefficient,
which measures the internal consistency reliability of a scale
or test by assessing the degree to which its items are correlated with one another. The internal consistency of the instrument was considered excellent (>0.9), with a Cronbach’s alpha
coefficient of 0.9689,
indicating that the items were strongly correlated and measured the same
construct; therefore, the questionnaire was considered reliable (Table 2).
RESULTS
Demographic Data
A
total of 323 physicians who were members of the Argentine Association
of Orthopedics and Traumatology participated
in the survey. The largest
proportion reported practicing general orthopedics and traumatology (25%), while the remainder were
distributed across 10 subspecialties (Table 3).
Overall, 78.3% of respondents had more than 10 years of professional experience
in the specialty.
General
orthopedics and traumatology showed a bimodal distribution according to years
of practice, with the highest proportions among physicians with less than 5
years of practice (51.6%) and those with more than 30 years (30.43%). More
recently developed subspecialties, such as shoulder and elbow surgery, peaked
among physicians with 6-10 years of practice (35.9%), whereas more traditional
subspecialties, such as hip and knee surgery,
were more heavily
represented among those with more than 30 years of practice (26.5%).
Regarding
the primary practice setting, 67.8% reported working at a private institution,
16.4% at a public institution, and 15.8% in private practice. In addition, the
proportion of physicians working in private practice increased with years of
professional experience.
Regarding geographic distribution (Figure 3), physicians from all regions
of the country participated, with a predominance of respondents from the Buenos Aires Metropolitan Area (AMBA) (52.6%),
defined as the area comprising the Autonomous City of
Buenos Aires and 40 surrounding municipalities in Buenos Aires Province.
Perception of Change
Sixty-two
percent of respondents reported having perceived a very significant change in
the methods used to access imaging study
results since the beginning of the pandemic
(over the past 5 years),
whereas only 0.62%
reported no change.
The perception of change was directly related
to years of professional practice.
It was considered very significant by 42% of physicians with up to 5 years of practice,
compared with 72% of those with more than
30 years of experience.
Geographically, the greatest impact of these changes was observed in regions with larger urban centers, such as
the AMBA, the Pampas Region, and northwestern Argentina.
The impact was most pronounced among physicians in private practice,
78% of whom rated the change as very
significant, compared with 58.5% and 58.9% of those working in public and
private institutions, respectively.
Finally,
the subspecialties in which physicians reported the greatest impact were
orthopedic oncology, spine surgery, and hip and knee surgery.
Level of Satisfaction
Fifty
percent of respondents who perceived changes reported being slightly or not at
all satisfied. Within this group, the highest
proportion of respondents who were “not at all satisfied” was observed among physicians with more than 30 years of practice
(28.26% of that subgroup).
Regarding geographic distribution, the highest level of
dissatisfaction was recorded in the AMBA, where 69.42% reported
being slightly or not at all satisfied. In contrast, the Cuyo region had the
lowest level of dissatisfaction, with 20% of respondents falling into the same
category.
Regarding
practice setting, 53% of respondents who based their answers on their private
practice reported dissatisfaction, compared with 49.3% of those working in
private institutions and 49% of those working in public institutions.
Finally, the subspecialties reporting the highest levels
of dissatisfaction were orthopedic oncology, spine surgery, and
hip and knee surgery.
Impact of the Lack of Printed
Imaging Studies
Forty percent
of respondents reported
being frequently or very frequently affected by the lack of printed imaging studies. Once again, years of
professional practice influenced this perception: the proportion reporting a
negative impact was highest among physicians with more than 30 years of
practice, 57.6% of whom reported being frequently or very frequently affected.
Physicians
in the AMBA were the most affected
(54%), whereas those in the Cuyo region reported the lowest impact (7%).
Physicians working
in public institutions reported the greatest
impact (53%), followed
by those in private practice (47%). In contrast, the impact
was lower among physicians working in private institutions (35%).
Difficulty Accessing
Imaging Studies
A total of 49.9% of respondents reported experiencing difficulties accessing imaging studies
frequently or very frequently, whereas only 0.93%
reported never having encountered any difficulties. Among physicians in the
AMBA, 68% reported frequent difficulties, whereas orthopedic surgeons in the
Cuyo region reported the lowest level of difficulty (13%).
Physicians
working in public institutions reported frequent or very frequent difficulties
in 55% of cases, followed by those in private practice (53%); this percentage
was slightly lower among those working in private institutions (48%).
Regarding
subspecialties, spine surgeons reported the greatest impact (68%), whereas
sports orthopedics specialists were the least affected (20%).
Main Difficulties
For this question, participants were offered five response options:
• The patient
forgets to bring the printed imaging studies.
• The imaging provider’s platform cannot be
accessed.
• The imaging studies
are difficult to view on the patient’s mobile phone.
• The studies were not uploaded correctly.
• All of the above.
The most frequent response
was “all of the above” (49.9%), followed
by inability to access the imaging platform (35%). Physicians with more than 30 years of practice (28.5%)
and spine subspecialists (64%) were the groups that most frequently reported encountering
all of the aforementioned problems.
Accessibility of Digital
Platforms
A total of 56% of respondents considered the platforms
difficult to use. Once again, spine specialists reported the most
negative assessment, whereas sports orthopedics specialists reported the most
favorable perception.
Impact of the Changes
on Clinical Practice
Only
28.5% of respondents reported that the changes in access to imaging studies had
little or no negative impact on their
clinical practice. A total of 24.5% indicated that the negative
impact occurred occasionally, whereas 47% reported that it occurred frequently or very
frequently.
The lowest negative impact was observed
among physicians with less than 5 years of practice
(35.5%), whereas the highest
was reported by those with more than 30 years of practice (63%).
Geographically, the worst results were recorded in the AMBA,
where 65% of responses were “frequent” or “very frequent.” In the Cuyo region, the impact was lower, with only 13%
reporting “frequent” and none reporting “very frequent.”
Regarding
practice setting, physicians working in public institutions (53%) and private
practice (51%) were the most
affected, compared with those working in private institutions (45%). Regarding
subspecialties, spine surgeons reported the greatest negative impact (63%),
whereas sports orthopedics specialists were the least affected (16%).
Diagnostic Ability
Twenty-seven percent
of respondents considered that the new system could
frequently (18%) or very frequently (9%) affect their diagnostic
ability. Consistent with previous findings, this perception was more common
among physicians with more than 30 years of practice (37%) and less common
among those with less than 5 years of experience (16%). Geographically, the
greatest impact was observed in the AMBA
(35% reporting “frequent” or “very frequent”), whereas no responses in these
categories were recorded in the Cuyo region.
Regarding
practice setting, private practice was the most affected (35% reporting
“frequent” or “very frequent”), whereas the impact was lower in private
institutions (24%).
Regarding
subspecialties, spine surgeons reported the greatest impact (36% reporting
“frequent” or “very frequent”), whereas sports
orthopedics specialists reported
a lower impact (12% “frequent” and 0% “very frequent”).
Time Consumption
A total of 29.5% of respondents estimated that attempts to access images could take up as much as 40–50% of the consultation time. No
significant differences were observed according to years of practice, although
geographic differences were evident. Once again, physicians in the AMBA were the most affected: 45% of
respondents spent more than 40% of
the consultation time
attempting to access images, whereas physicians in the Cuyo region were the least affected
(7%).
No
significant differences were found according to practice setting. Regarding
subspecialties, spine specialists reported the greatest impact (54%), whereas
sports orthopedics specialists were the least affected (8%).
Image Quality
Twenty-four percent
of respondents considered image quality to be inferior
to what they had previously experienced; 27.5% rated it as equivalent, 38.5% as better,
and 10% as much better.
Physicians with more than 30 years
of practice had the most negative perception, with 40% considering image
quality to be worse or much worse, compared with only 13% among those with less
than 5 years of practice.
The
perceived decline in quality was most pronounced in the AMBA (32%) and least pronounced in the Patagonia region (3%).
Regarding practice
setting, the worst results were reported by physicians in private practice
(35%), followed by those working in public institutions
(26.5%) and, to a lesser extent, private institutions (20.5%).
Regarding
subspecialties, physicians specializing in spine surgery (23%) and hip and knee
surgery (40%) reported the worst results, whereas the negative perception was
much less frequent among sports orthopedics (8%) and orthopedic oncology
specialists (0%).
Training
A
total of 92.24% of respondents reported that they had not received any training
on accessing and navigating digital platforms. All participants from the Cuyo
region (n = 15) reported having received no training, whereas physicians from
northwestern Argentina had the
highest rate of training (26%). No significant differences were observed
according to practice setting, although the lowest training rate was reported
in private practice (5.8%) and the highest in public institutions (9.6%).
DISCUSSION
The
survey findings reveal a marked change in access to imaging study results in
the field of orthopedics and traumatology over the past five years,
particularly since the COVID-19 pandemic. A
significant level of dissatisfaction with current methods of accessing imaging
studies was observed. The most affected were physicians with more years of
professional experience, those working in private practice, and those located
in the AMBA. Conversely, the least
affected were specialists with less than 5 years of practice, those working in
private institutions, and those in the Cuyo region.
Regarding
subspecialties, spine surgeons reported the highest levels of dissatisfaction,
whereas sports orthopedics specialists reported the lowest. It should be noted
that the sample size and practice settings of both groups were comparable;
therefore, these differences were not influenced by these variables.
Most
respondents had not received any training from imaging service providers or the
institutions where they worked; the changes were implemented without formal
training. Nearly 50% expressed dissatisfaction with the new methods, a similar
proportion reported frequent difficulties accessing information, and 47%
reported a frequent or very frequent negative impact on their clinical
practice. Furthermore, 27% considered that the changes could affect their
diagnostic ability. It also became evident that accessing imaging studies can
consume a considerable proportion of consultation time: nearly 30% of
respondents indicated that attempts to access images could take up as much as
40-50% of the consultation time. As reported in other studies,10 the worst
conditions were observed in the AMBA.
In
contrast, experiences in other settings have shown more favorable results
following changes in methods of accessing images. Kruger et al.1 reported that
94.5% of surgeons considered that the transition from physical to digital
images improved access to imaging studies. Wojciech et al.11 evaluated the
introduction of the DICOM system and found that, in 90% of cases, digital
images were successfully accessed on the first attempt.
Lindsay et al.12 reported that
the implementation of PACS improved report turnaround time (70%) and medical
staff work-flow (57%). Jorwekar et al.13 reported a 94% satisfaction rate among respondents following implementation of the
same system. Chan et al.14 found that referring physicians almost
unanimously preferred PACS to printed films, and 91% reported improved
productivity.
Why,
then, is the perception in our setting so different? The medical literature
suggests that users will adopt new technologies only if they perceive that they make their work easier;15 however, the results of our survey
show that this is not the case for many surgeons in our setting.
It has
been proposed that the performance of a radiology center should be assessed
according to six variables: productivity, report turnaround time, ease of access, finances,
and physician and patient satisfaction.12 In practice,
healthcare intermediaries prioritize patient/client satisfaction, considering
indicators such as complaints, satisfaction, and waiting times.15,16 However,
referring physicians, particularly those in private practice, are the true
primary clients,16 as they generate the demand for imaging studies
and must use their results. Despite this, their opinions are rarely taken into account when changes are implemented or platforms
are selected. This reflects a failure to recognize specialists as “clients” in
the provision of imaging services.
Physicians frequently receive poor-quality studies,
images deemed unsuitable for diagnosis by the imaging
provider itself (Figure 1), inaccurate reports (Figure 4), inadequate images (Figure 5), inaccessible platforms (Figure 6),
and data upload errors (Figures 7 and 8).
Faced with these situations, the orthopedic surgeon must choose between making
decisions based on inadequate studies or referring the patient back to have the examinations repeated, resulting in further
difficulties and delays.
Clearly,
the failure of imaging providers to identify the primary user hinders the
implementation of improvements aimed at increasing physician satisfaction.
Limitations
This
study has some limitations. First, the sample size is relatively small compared
with the total population of orthopedic and trauma specialists in Argentina. The survey format, with
predefined response options, may have limited the diversity of responses. In
addition, the data were self-reported, which may have introduced response bias
or resulted in incomplete information.
Strengths
This is the first study to assess the perceptions of orthopedic and trauma specialists regarding access to imaging
study results in Argentina.
Strategies were implemented to mitigate bias, including anonymous
participation, and the study received institutional support.
CONCLUSIONS
To our
knowledge, this survey is the first study to assess the perceptions of Argentine orthopedic and trauma
specialists regarding access
to imaging study
results. Compared with international experiences, the level of dissatisfaction
was high. The vast majority of physicians had received
no training in the new methods of access.
The
main contribution of this study is to provide an assessment of the current
situation that may help ensure that orthopedic surgeons are recognized as
relevant stakeholders and that their perspectives are considered when
implementing technological changes in access to imaging studies.
REFERENCES
1. Kruger P, Lynskey S, Sutherland A. Are orthopaedic surgeons
reading radiology reports?
A Trans-Tasman Survey.
J Med Imaging Radiat
Oncol 2019;63(3):324-8. https://doi.org/10.1111/1754-9485.12871
2. Olthof AW, Shouche P, Fennema
EM, IJpma FFA, Koolstra RHC, Stirler VMA, et al. Machine
learning based natural
language processing of radiology reports in orthopaedic
trauma. Comput Methods Programs Biomed 2021;208:106304. https://doi.org/10.1016/j.cmpb.2021.106304
3. Fridell K, Aspelin P, Felländer-Tsai L, Lundberg
N. The effect of PACS on the practice of orthopaedic surgeons. J Telemed Telecare 2011;17(3):137-41. https://doi.org/10.1258/jtt.2010.100107
4. Wade FA, Oliver CW. Living with digital imaging.
Clin Orthop Relat
Res 2004;(421):25-8. https://doi.org/10.1097/01.blo.0000126870.74832.d7
5. Lutsky K, Leinberry C, Gallant
G, Takei R, Kwok M, Beredjiklian P. An evaluation of digital imaging
studies in an outpatient orthopedic setting. Arch Bone Jt Surg 2019;7(3):235-8.
PMID:
31312680
6. Juenemann S, Hasler C, Brunner R. Digital imaging
data on CD-R:
a time trap for orthopaedic surgeons
in outpatient clinics. J Child Orthop 2009;3(1):59-62. https://doi.org/10.1007/s11832-008-0150-9
7. Alderson PO. Customer service
and satisfaction in radiology. AJR Am J Roentgenol 2000;175(2):319-23. https://doi.org/10.2214/ajr.175.2.1750319
8. Camponovo EJ. Radiologist-patient contact: a different perspective. J Am Coll Radiol 2004;1(12):998-9; author reply 1000. https://doi.org/10.1016/j.jacr.2004.09.021
9. Pilling JR. Picture archiving and communication systems:
the users‘ view. Br J Radiol 2003;76(908):519-24.
https://doi.org/10.1259/bjr/67551353
10. Moya D, Gómez D, Vila M, Alfano F. ¿Somos los cirujanos argentinos de hombro y codo los peor tratados de Iberoamérica?
Comparación de los honorarios
y el nivel de satisfacción
entre los miembros de la Asociación Argentina de Cirugía de
Hombro y Codo, y los colegas de Iberoamérica.
Rev Asoc Argent
Ortop Traumatol 2022;87(4):540-58.
https://doi.org/10.15417/issn.1852-7434.2022.87.4.1593
11. Wojciech C, Hennrikus W, Kish A, Armstrong D. Use of CD-ROMS for digital image viewing during new pediatric orthopaedic consults - Do we need a standardized viewer for digital imaging? J Musculoskelet Disord Treat 2016;2(1): 006 pp:1-3. Available
at: https://pdfs.semanticscholar.org/d4c7/66a71cf8b0cb597493be7a188843cc8dea2d.pdf
12. Lindsay R, McKinstry S, Vallely S, Thornbury G. What influences clinician‘s satisfaction with radiology
services? Insights Imaging 2011;2(4):425-30. https://doi.org/10.1007/s13244-011-0099-y
13. Jorwekar GJ, Dandekar KN, Baviskar PK. Picture Archiving
and Communication System (PACS): Clinician‘s
perspective about filmless imaging. Indian
J Surg 2015;77(Suppl 3):774-7. https://doi.org/10.1007/s12262-013-0998-x
14. Chan L, Trambert M, Kywi A, Hartzman S. PACS in private practice--effect on profits and productivity. J Digit Imaging 2002;15(Suppl 1):131-6.
https://doi.org/10.1007/s10278-002-5019-8
15. Ondategui-Parra S, Bhagwat JG, Zou
KH, Nathanson E, Gill IE, Ros PR. Use of productivity and financial indicators for monitoring performance in academic radiology
departments: U.S. nationwide survey. Radiology 2005;236(1):214-9. https://doi.org/10.1148/radiol.2361040456
16. Hoe J. Quality service
in radiology. Biomed Imaging
Interv J 2007;3(3):e24. https://doi.org/10.2349/biij.3.3.e24
J. L. Osma Rueda ORCID ID: https://orcid.org/0000-0002-3240-4806
S. Focaraccio
ORCID ID: https://orcid.org/0000-0001-7199-9841
J. C. Uribe Caputi ORCID ID: https://orcid.org/0000-0002-4971-339X
S. Ávila Posada ORCID ID: https://orcid.org/0009-0008-8035-3522
M. Á. Flores Ruiz ORCID ID: https://orcid.org/0009-0007-6076-0641
F. Alfano
ORCID ID: https://orcid.org/0000-0003-1078-2600
D. Gómez ORCID ID: https://orcid.org/0000-0003-0258-6802
Received on April 3rd, 2026. Accepted after evaluation on May 10th, 2026 • Dr. DANIEL
MOYA • drdanielmoya@yahoo.com.ar • https://orcid.org/0000-0003-1889-7699
How to cite this article: Moya D, Osma Rueda
JL, Focaraccio S, Uribe Caputi
JC, Ávila Posada
S, Flores Ruiz MÁ, et al. Access
to Musculoskeletal Imaging
Studies in Argentina: Are Orthopaedic Surgeons
Mere Bystanders? Rev Asoc
Argent Ortop Traumatol 2026;91(4):330-342.
https://doi.org/10.15417/issn.1852-7434.2026.91.4.2336
Article
Info
Identification:
https://doi.org/10.15417/issn.1852-7434.2026.91.4.2336
Published: Agosto, 2026
Conflict
of interests: The authors declare
no conflicts of interest.
Copyright: © 2026, Revista de la Asociación Argentina de Ortopedia y
Traumatología.
License: This article is under Attribution-NonCommertial-ShareAlike 4.0 International Creative Commons License
(CC-BY-NC-SA 4.0).