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STUDY ON THE USE OF GONADAL SHIELDS IN PAEDIATRIC PELVIC X-RAYS



Abstract

To assess if paediatric patients are getting adequate gonadal protection whilst undergoing pelvic X-rays.

A retrospective study of 100 AP pelvic X-rays in 62 consecutive paediatric patients was performed. All children 16 years and under (mean = 8 years) who had an AP pelvic X-ray at our institution between 1st April 2004 and 1st July 2005 were included in the study. When reviewing the X-rays, the manufacturer’s guidelines for ideal shield size and position were strictly followed to assess whether adequate gonadal protection was being achieved (the lead shield must be completely covering the true pelvis in girls and the scrotum in boys). A subsequent questionnaire survey involving 20 radiographers was carried out.

In 78 cases gonadal protection was inadequate. This was unrelated to the child’s age or sex. In 72 cases shield position and in 11 cases shield size was incorrect. The survey showed that 40% of radiographers believed that the gonadal shield was either difficult to use or had a poor design. Twenty percent felt they had received inadequate training.

Gonadal shields reduce radiation exposure of the reproductive organs during pelvic X-rays. Many designs are available on the market but not all designs function adequately. Our study showed that a poor design of gonadal shield can cause unnecessary radiation exposure. We present this audit to make people aware of this poor design and recommend that a detailed market survey prior to buying such equipment and subsequent training of staff in its proper use must be carried out.

Correspondence should be addressed to Mr Bimal Singh, BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE