You receive radiographs taken elsewhere for a new patient. What should be checked FIRST?

Correct answer: C. Whether the image quality is diagnostically acceptable

• A. Diagnosis comes after the quality assessment. Interproximal overlap alone can hide a lesion completely, which is precisely why quality is checked first.
• B. Correct identification and dating matter and must be verified, but they are administrative checks that follow the assessment of whether the image can be read at all.
• C. CORRECT. Before any interpretation, establish whether the images are DIAGNOSTIC. Check density, contrast, coverage of the intended anatomy, and the presence of positioning errors such as cone cut, elongation, foreshortening or overlap. Interpreting a non-diagnostic film is worse than having no film at all, because it creates false confidence and may lead you to miss disease.
• D. Records transfer requires patient authorization, but that is handled at the point of request rather than being the first clinical step in reviewing the image.

Note: If the films are inadequate, retaking them is justified — ALARA does not require accepting a non-diagnostic image. Document why the retake was necessary. Conversely, if the outside films ARE diagnostic and current, retaking them purely as a matter of routine violates the principle of justification.