The most typical mistakes made during pelvic X-ray in pediatric patients typical mistakes made during pelvic X-ray

Year 2022, Volume: 5 Issue: 3, 805 - 808, 30.05.2022

Mahmud Aydın , Serkan Surucu , Onur Ozel , Onur Demırsu , Murat Yılmaz

https://doi.org/10.32322/jhsm.1082531

Abstract

Aim: This study aimed to identify the most common mistakes made during pelvic radiography in pediatric patients and to give advice to physicians and technicians on how to avoid these mistakes.
Material and Method:Between 2016 and 2020, 1150 pelvic radiographs (in pediatric patients for any reason) were analyzed by two independent orthopaedic surgeons. Radiographs taken in trauma patients were not included in the study due to the patient's discomfort and agitation. Interobserver and intraobserver reliability for radiographic measurements were determined using intra-class correlation coefficients (ICC) obtained from three replicate sets of measurements on a sample of 1150 radiographs recorded by each observer at least one week apart.
Results: The mean age of the patients included in this study was 4.28±3.86 (range: 0-14) years. Of the 1150 patients, 935 (81.30%) were female and 215 (18.69%) were male. When pediatric pelvic radiographs were evaluated, the most common mistake was made during gonad protection. It was found that 71.22% of the patients' gonads could not be protected. While this rate was 82.24% in female patients, this rate was 23.34% in male patients. There was a statistically significant difference when compared by gender (p= 0.015). Giving the malposition was the second most common mistake.
Conclusion: The most common errors in pediatric pelvic radiographs are failure to provide gonad protection and malposition of the patient. To minimize these errors, it is necessary to inform both the doctor and the technician.

Keywords

Gonad protection, malposition, pediatric patients, pelvic radiography.

Supporting Institution

S.B.U Haseki Training and Research Hospital

Thanks

We thank the hospital management and ethics committee for allowing us to use our hospital data.

References

• Kutanzi KR, Lumen A, Koturbash I, Miousse IR. Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations. Int J Environ Res Public Health 2016; 13: 1057.
• Kleinerman RA. Cancer risks following diagnostic and therapeutic radiation exposure in children. Pediatr Radiol 2006; 36: 121-5.
• Khong PL, Ringertz, H, Donoghue V, et al. Radiological protection in pediatric diagnostic and interventional radiology. Ann. ICRP 2013; 42: 1-63.
• Bisset GS, Crowe J. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites. Pediatr Radiol 2014; 44: 552-7
• Menashe SJ, Iyer RS, Parisi MT, Otto RK, Weinberger E, Stanescu AL. Pediatric abdominal radiographs: common and less common errors. AJR Am J Roentgenol 2017; 209: 417-29.
• Menashe SJ, Iyer RS, Parisi MT, Otto RK, Stanescu AL. Pediatric chest radiographs: common and less common errors. AJR Am J Roentgenol 2016; 207: 903-11.
• Wainwright AM. Shielding reproductive organs of orthopaedic patients during pelvic radiography. Ann R Coll Surg Engl 2000; 82: 318-21.
• Liakos P, Schoenecker PL, Lyons D, Gordon JE. Evaluation of the efficacy of pelvic shielding in preadolescent girls. J Pediatr Orthop 2001; 21: 433-5.
• Gürsu S, Gürsu T, Çamurcu Y, Yıldırım T, Gürsu A, Şahin V. Efficacy of gonadal shielding in pediatric pelvis X-rays. Eklem Hastalik Cerrahisi 2013; 24: 87-90.
• Alzyoud K, Hogg P, Snaith B, Flintham K, England A. Optimum positioning for anteroposterior pelvis radiography: a literature review. J Med Imaging Radiat Sci 2018; 49: 316-24.
• Kloth JK, Neumann R, von Stillfried E, et al. Quality-controlled dose-reduction of pelvic X-ray examinations in infants with hip dysplasia. Eur J Radiol 2016; 85: 233-8.
• Fawcett SL, Barter SJ. The use of gonad shielding in pediatric hip and pelvis radiographs. Br J Radiol 2009; 82: 363-70.
• Kaplan SL, Magill D, Felice MA, Xiao R, Ali S, Zhu X. Female gonadal shielding with automatic exposure control increases radiation risks. Pediatr Radiol 2018; 48: 227-34.
• Kumar A, Chau WW, Hung AL, Wong JK, Ng BKW, Cheng JCY. Gonadal shield: is it the Albatross hanging around the neck of developmental dysplasia of the hip research? J Child Orthop 2018; 12: 606-13.
• Li RT, Hu E, Gould H, Valentin N, Salata MJ, Liu RW. Does pelvic rotation alter radiologic measurement of anterior and lateral acetabular coverage? Arthroscopy 2019; 35: 1111-6.
• Brockmeyer M, Lott S, Stroeder J, et al. Simple mechanical devices did not improve pelvis positioning in AP pelvis radiographs for reliable assessment of the acetabular orientation. J Exp Orthop 2019; 6: 20.
• Vogel E, Leaver T, Wall F, Johnson B, Uglow M, Aarvold A. Repeated pelvic radiographs in infants, after harness treatment for developmental dysplasia of the hip, carry very low radiation risk. Indian J Orthop 2021; 55: 1543-8.