Radiographs of the pelvis and hips are usually obtained in the anterioposterior (AP) supine position. However, some previous studies advocate obtaining pelvis radiographs in non-traumatic patients in the erect position, as it provides more diagnostically useful information [1-4]. However, in larger patients, the authors reported decreased image quality and increased radiation dose in erect pelvic radiography due to the greater thickness in the pelvic region as the soft tissue sink inferiorly due to gravity [5,6]. Based on the above, we wanted to investigate whether the...

Phantom Study In the first part of the study, we determined which band did not produce visible artefacts on the acquired images when the adipose tissue was displaced. We simulated a patient with an antropomorphic phantom RS-13T with its back side facing the vertical stand. The first stage of obesity was simulated with catering lard wrapped in cling film. We placed it on the front surface of the phantom and secured it by wrapping the cling film around the phantom. We collected bands of four...

A thin triangular cotton bandage showed no visible artefacts. In a group of patients in whom the adipose tissue was elevated, the thickness around the waist decreased by 4.7% after tissue displacement (p<0.001), while the hip circumference remained the same (p=0.211). In the tissue displacement group, DAP was 38.5% lower (p=0.001), ESD was 44% lower (p<0.001), and effective dose was 38.7% lower (p<0.001), see Figure 2, 3 & 4. Hip joints (p=0.001), trochanters (p=0.021), acetabula (p<0.001), femoral necks (p=0.021), medulla and cortex of the pelvis...

In erect pelvic radiography, the patient dose-area product, the entrance skin dose and effective dose decrease as adipose tissue is removed from the region of interest. This also affects image quality, as most pelvic anatomic structures are better visualised. Based on the results, we recommend taking pelvic radiographs in the upright position in overweight and obese patients, with removing the fatty tissue with a band that does not cause artefacts on the image, so that image quality improves and the received effective dose is as...

Š. Trožić: Nothing to disclose A. England: Nothing to disclose N. Mekis: Nothing to disclose

[1] Flintham K, Alzyoud K, England A, Hogg P and Snaith B 2021 Comparing the supine and erect pelvis radiographic examinations: an evaluation of anatomy, image quality and radiation dose Br. J. Radiol. [2] Alzyoud K, Hogg P, Snaith B, Flintham K and England A 2018 Optimum Positioning for Anteroposterior Pelvis Radiography: A Literature Review J. Med. Imaging Radiat. Sci. 49 316–24 [3] Jackson T J, Estess A A and Adamson G J 2016 Supine and Standing AP Pelvis Radiographs in the Evaluation of Pincer...