Radiography of the pelvis and hip is commonly performed in assessing hip pathologies in pediatrics. The European Directive on health protection identifies children as a special practice that merit particular attention from the radiation protection point of view, mainly due to the increased radiosensitivities of tissues and lifetime risk for carcinogenesis in the pediatric group. Radiation protection during radiography of the pelvis has always been portrayed as challenging due to the location of the gonads. It is the professional responsibility of the radiographer to ensurethat...

Retrospective data collection of all pelvic, hip and scoliosis radiography performed in our hospital from September 2017 to March 2018, for patients under 18 years of age are included. Radiographs performed as part of major trauma series are excluded from the study. Using the ICRP publication 121: Radiological Protection in Paediatric Diagnostic and Interventional Radiology as the reference standard, the radiographs were reviewed by a paediatric radiologist. For each examination, the image is assessed to determine 1) the presence or absence of gonad protection, and...

Total 158 examinations were included from September 2017 to March 2018 (Phase I). Gonad protection were only present in 27.2% (43/158), with overall accuracy of placement of 51.2% (22/43). In view of the unsatisfactory performance, changes were implemented (to be discussed below). The re-audit phase (Phase II) was conducted in June 2018 to September 2018, including total 111 examinations. Gonad protection were used in 60.4% (67/111), which showed significant interval improvement compared to previous phase, though overall correct placement rate remained similar at 55.2%. Details...

The re-audit after implementation of changes to raise awareness and compliance among radiographers have significantly increased the use of gonad protection in pediatric population, even though results in phase II did not meet our pre-set target. Further improvement can be anticipated upon further education and reinforcement of the guidelines and recommendations in the future.

International Commission on Radiological Protection. ICRP publication 121: radiological protection in paediatric diagnostic and interventional radiology. Ann ICRP 2013;42(2). Radiation Health Series No.1 Guidance Notes on Radiation Protection for Diagnostic Radiolgy (2004). Radiation Health Unit, Department of Health, Hong Kong. Teunen D. The European directive on health protection of individuals against the dangers of ionising radiation in relation to medical exposures (97/43/ EURATOM). J Radiol Prot 1998;18(2):133e7. ACR–SPR–SSR Practice Parameter for the Performance of Radiography for Scoliosis in Children (2014). T. Warlow et al. Gonad...