Can AI Language Models Interpret X-rays?
No, I cannot read or interpret x-ray images—I am a text-based AI without image processing capabilities, and x-ray interpretation requires specialized training, visual analysis skills, and clinical context that only qualified radiologists and trained physicians possess. 1
Who Should Interpret X-rays
Qualified Interpreters
- X-ray interpretation must be performed by physicians with appropriate training, experience, and competence, typically radiologists who are board-certified and licensed in the state where images are obtained 1
- Emergency physicians may perform contemporaneous interpretations within the limits of their training and institutional credentialing, but this should follow quality assurance protocols 1
- All preliminary interpretations by non-radiologists should be followed by formal radiologist review, with any discrepancies communicated back to the treating physician in a timely, documented fashion 1, 2
Training Requirements
- Radiologists require extensive specialized training to recognize normal anatomy, pathological findings, and potential pitfalls 1
- Even experienced readers can have difficulty interpreting plain x-rays, particularly when non-infectious changes or complex pathology is present 1
- Interpretation errors occur in approximately 4% of radiologic readings in daily practice, with discrepancy rates of 2-20% in reports 3
Common Interpretation Challenges
Types of Errors
- Perceptual errors occur when abnormalities are simply not seen on images 4
- Cognitive errors occur when findings are detected but their meaning is not correctly understood 4, 5
- Error rates increase in emergency settings and during early training periods 3
Critical Pitfalls
- Normal x-rays do not exclude pathology—for example, chest radiographs are normal in 11-62% of diaphragmatic hernias, and plain x-rays are insensitive to acute osteomyelitis 1, 6
- Interobserver agreement can be only moderate even among trained clinicians 1
- Interpretation requires clinical context, patient history, and correlation with physical examination findings 1, 3
Proper Use of X-ray Interpretation
Quality Assurance Requirements
- All x-ray interpretations require quality assurance processes including peer review, discrepancy tracking, and continuing education 1, 2
- Preliminary reports must be clearly identified, time-stamped, and followed by final radiologist interpretation 1
- Any changes from preliminary to final reports must be communicated reliably to the ordering provider and documented 1
Communication Standards
- Critical findings require immediate verbal communication through closed-loop communication to the ordering provider 1
- Off-site teleradiology interpretation must follow institutional and American College of Radiology guidelines, with credentialing by the hospital medical staff 1
- Organizations must ensure 24/7 availability of qualified interpretation services 1