Twenty radiographs showing subtle orthopaedic findings were transmitted to three emergency physicians. Fifty-seven of the 60 attempted diagnoses were correct. We found the primary radiographic film had to be well centred, exposed, true and penetrated for successful transmission. There is a considerable element of familiarization with the technology. The software should permit simultaneous annotation from the two sites and additional cameras are necessary to enable emergency nurse practitioners (ENPs) to show the injured part. The 20 radiographs took 120 min to interpret with teleradiology rather than 10 min of viewing conventional films. The extra time for teleradiology is due to readers asking for multiple areas of the radiographic image to be enlarged before making a decision. We feel that ENPs should not engage in teleradiology but rather telemedical consultation.