The radiographs of 337 patients attending the casualty department of a large teaching hospital were reviewed by two medical students of different seniority, a radiology registrar and a consultant radiologist. All the films had been examined initially by the casualty officer when the patient attended. The senior medical student reported the films more reliably than the junior student and was only slightly less reliable than the casualty officer. The radiology registrar was more accurate than the casualty officer where both reports could be compared with the consultant's opinion. Only rarely did the consultant radiologist disagree with the radiology registrar but in one patient this led to a change in management. The need for a radiological opinion has been confirmed.