Efficacy of gonadal shielding in pediatric pelvis X-rays
Sarper Gürsu1, Türkan Gürsu2, Yalkın Çamurcu1, Timur Yıldırım1, Alper Gürsu3, Vedat Şahin1
1Metin Sabancı Baltalimanı Kemik Hastalıkları Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye
2Başkent Üniversitesi İstanbul Sağlık, Uygulama ve Araştırma Merkezi, Kadın Hastalıkları ve Doğum Uzmanı, İstanbul, Türkiye
3Başkent Üniversitesi Ankara Hastanesi, Çocuk Sağlığı ve Hastalıkları Kliniği, Ankara, Türkiye
Keywords: Gonad; pediatric; pelvic; radiation effect.
Objectives: In this study, we evaluated the efficacy of using gonadal shielding in pediatric patients.
Patients and methods: Between October 2011 and February 2012, 1137 pelvic X-rays of 675 consecutive patients (323 boys, 352 girls; mean age 6.8 years; range 6 month to 17 years) in our hospital were evaluated in terms of gonadal shielding use by a team including an orthopedist, a gynecologist and a pediatrician.
Results: Gonadal shields were used in 566 (49.8%) pelvic X-rays of 1137 patients and important anatomical landmarks were left open in 506 (44.5%) of them. In 104 (9.1%) X-rays, the shields were placed in correct position. It was observed that a total of 293 (25.7%) X-rays were partially protective, while 109 (9.6%) X-rays were placed in a totally wrong position. Nineteen X-rays (3.3%) were repeated due to malposition of the gonadal shielding. In X-rays of boys, gonadal shields were used for 193 (17%); however only 74 (6.5%) of them were placed in correct position. In X-rays of girls, gonadal shields were used for 373 (32.8%); however only 30 (2.6%) of them were protective.
Conclusion: If we take into consideration that use of pelvic X-rays is essential and indispensable for the diagnosis of many pediatric pelvic diseases, we believe that technicians who are responsible for taking these X-rays should be better trained on the use of gonadal shields and designs of gonadal shields should be improved.