Radiological Findings of Chest X-Rays During the Hajj Seasons 1444-1445 H/2023-2024 G: Diagnostic Quality and Gender Differences in Interpretation Concordance.

: Mass gatherings like the Hajj pilgrimage present unique challenges for radiological services, with high patient volumes and increased respiratory disease risks necessitating reliable chest X-ray interpretation.: The objective of this study is to assess the diagnostic quality, abnormality rates, and peer-review concordance of chest X-rays in patients transferred during the Hajj seasons of 1444-1445 H/2023-2024 G, with an additional focus on gender-based differences in radiological interpretation.: A cross-sectional analysis of 2093 chest X-rays from Hajj healthcare facilities was conducted. Two blinded radiologists independently reinterpreted images using standardized criteria. Data included demographic variables, radiographic findings (quality, opacities, nodules, cardiomegaly, effusions), and tuberculosis likelihood.: Among interpretable films (89.7% acceptable quality), 69.2% showed abnormalities, primarily opacities (56.4%) and cardiomegaly (27.0%). Tuberculosis was considered probable by radiographic appearance in 21.0% of cases. Peer review demonstrated 94.2% overall concordance. Regression analysis identified the presence of any abnormality (OR = 10.67,< 0.001) and female gender (OR = 2.97,= 0.003) as significant independent predictors of interpretive discordance. A trend towards higher discordance was noted for pulmonary nodules, though it was not statistically significant (9.4% vs. 5.6%,= 0.062).: While chest X-rays proved reliable for Hajj screening, gender disparities in interpretation and challenges in certain assessments, such as nodule evaluation, highlight opportunities to refine radiological protocols in mass gatherings.