I am a private practice radiologist specializing in musculoskeletal (MSK) radiology. I first began using OsiriX many years ago when our group migrated to a Windows based PACS. I found the PACS, and Windows in general, counterintuitive. In particular I was drawn to OsiriX because of its ease of use, strong support community, and the fast response of the developers to issues that users would bring to their attention.
One of the areas where I find OsiriX most useful is in MDCT. Typical MSK CTs have thousands of images. In areas of complex anatomy, such as the foot/ankle, wrist and spine it is very useful to have rapid 3D volume rendering and multiplanar reformation. While our technologists routinely do standard 3-plane reformations, particular pathology (e.g. Lisfranc injuries) can benefit from radiologist guided reformations specific to the area of pathology. Additionally, I have found the rapid multiplanar reformations of OsiriX to be very useful in analyzing CT arthrograms. This is particularly true for assessing subtle SLAP lesions or meniscal tears. These images can be exported to PACS.
A third area where OsiriX excels is the ROI tools. The Cobb angle tool is a life saver. In fact, the multi-million dollar PACS system that our group purchased doesn’t even include this basic functionality. I read many MRIs and there again the ROI functions have been especially useful in measuring the tibial tuberosity trochlear groove distance. Once measured, the image can be easily exported to the PACS for future reference and for clinician access.