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Pelvic shields for diagnostic imaging often misplaced in pediatric patients
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Although pelvic shields for diagnostic imaging for orthopedic pathology in children are rarely absent, recently published results showed these shields are often misplaced.
“Pelvic lead shields when placed on children for routine pelvic radiographs are highly ineffective in achieving their goals of protecting the radiosensitive gonads,” Mark C. Lee, MD, told Healio.com/Orthopedics. “The orthopedic surgeon should consider simply abandoning the practice until a more effective method is developed, as it adds time to the study and risks a repeat study since bony landmarks are obscured in up to 51% of cases.”
From 3,400 pediatric patients who had an anteroposterior or frog lateral pelvic radiograph between 2008 and 2014, Lee and colleagues randomly selected 84 boys and 84 girls for review. Researchers calculated the percentage of incorrectly positioned or missing shields in both boys and girls.
Results showed 49% and 63% of anteroposterior and frog lateral radiographs, respectively, were misplaced. Researchers noted 76% of girls had a misplaced pelvic shield on frog lateral radiographs vs. 51% of boys.
According to results, pelvic shielding obscured pelvic bony landmarks with a frequency of 7% to 43%, depending on the specific landmark. Researchers found a shield on anteroposterior images was significantly more likely to block visualization of the ilium, iliac crest and sacroiliac joint for girls and the ischium and pubis for boys. A shield on frog lateral images was significantly more likely to block visualization of the sacroiliac joint for girls and the pubic symphysis or ischium for boys. Researchers found shielding obscured the femoral head and acetabulum in up to 2% of all images. – by Casey Tingle
Disclosure s : The researchers report no relevant financial disclosures.
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