title: Shielding during x-ray examination of pediatric female patients with developmental dysplasia of the hip.
abstract: Patients with developmental dysplasia of the hip (DDH) generally undergo multiple x-ray examinations of both hip joints. During these examinations, the gonads are completely exposed to radiation, unless shielded. Although many types and sizes of gonad shields exist, they often do not provide adequate protection because of size and placement issues; additionally, these shields are frequently omitted for female patients. Our aim was to assess gonad protection during x-ray examination that is provided by gonad shields designed for individual female patients with DDH.We retrospectively retrieved data from the Picture Archiving and Communication System database; pelvic plain x-ray films from 766 females, 18 years old or younger, were included in our analysis. Based on x-ray measurements of the anterior superior iliac spine, we developed a system of gonad shield design that depended on the distance between anterior superior iliac spine markers. We custom-made shields and then examined shielding rates and shielding accuracy before and after these new shields became available. Standard (general-purpose) shields were used before our custom design project was implemented. The shielding rate and shielding accuracy were, respectively, 14.5% and 8.4% before the project was implemented and 72.7% and 32.2% after it was implemented. A shield that is more anatomically correct and available in several different sizes may increase the likelihood of gonad protection during pelvic x-ray examinations.
authors.affiliation: Department of Diagnostic Radiology, National Cheng-Kung University College of Medicine and Hospital, Taiwan, Republic of China.
authors.forename: Yi-Shan
authors.initials: YS
authors.lastname: Tsai
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Liu
authors.forename: Ming-Tsung
authors.initials: MT
authors.lastname: Chuang
authors.forename: Chien-Kuo
authors.initials: CK
authors.lastname: Wang
authors.forename: Cheng-Shih
authors.initials: CS
authors.lastname: Lai
authors.forename: Hong-Ming
authors.initials: HM
authors.lastname: Tsai
authors.forename: Chii-Jeng
authors.initials: CJ
authors.lastname: Lin
authors.forename: Chia-Hsing
authors.initials: CH
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D001175:Arthrography / Q000295:instrumentation* / Q000706:statistics & numerical data; D001822:Body Burden; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059351:Organ Sparing Treatments / Q000295:instrumentation* / Q000379:methods; D058958:Organs at Risk / Q000528:radiation effects*; D010053:Ovary / Q000528:radiation effects*; D061214:Patient Safety; D011829:Radiation Dosage; D011835:Radiation Protection / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity