When I worked at Birmingham Accident Hospital, something always commented on by junior doctors was the lack of scanning equipment - we didn't even have a CT scanner, even though we were the brain injuries unit for the area. The consultants never pushed for it either, because they said that having a scanner meant that you would use it, rather than using clinical judgement to make the right decision at the right time. For example, when someone has come in with head trauma you need to know if you need make a burr hole (to relieve pressure on the brain), rather than sending the patient for a scan which takes time in which they could be bleeding more and thus becoming more brain injured. When you assess a person's injury after head trauma, you should be able to tell where the injury has been by their signs and symptoms alone, without needing a scan.

This probably goes too far nowadays, when scans are more widely available, but looking at the Wayne Rooney fracture, it certainly does seem like clinicians are being de-skilled by having scanners - relying more on the scans, and losing the diagnostic and prognostic (not sure if that's a word!) skills previous clinicians had.

'In my day' (since I have used that phrase, I am now officially and Old Woman), if someone had wanted to know if a person was ready to do something after injury, we would use our clinical judgment. In Wayne Rooney's case, I'd still back my clinical judgement against a scan result. That is because a scan only shows how the bone and possibly the tissues are healing. It isn't taking any of Rooney's own personal physiology into account. A scan can't tell you how much pain a person feels, how mobile the joints are, or how strong the surrounding musculature is. There's no point scanning; you need to feel, question and look. To me it seems like the scan has become the be-all and end-all, rather than a tool which can provide just part of the clinical picture.

And we have little idea of the side effects of repeated scans (one of which could turn out to be delayed fracture healing, for all we know).