Study on the use of gonadal protection shields during paediatric pelvic X-rays

Background: There are national guidelines issued by all hospital radiology departments concerning the use of gonadal protection shields for taking X-rays of the pelvis. It is important to follow these guidelines especially when paediatric X-rays are taken. Gonads are very susceptible to radiation as they fall directly in the line of radiation exposure when pelvic X-rays are taken. Aim: To examine whether these guidelines were being followed. Methods: This audit considered 355 radiographs taken in a 6-month period on 149 patients, under the age of 16 years, attending the orthopaedic department at King's Mill Hospital. Results: In only 23% of the cases studied, the correct use of gonad protection shields had been performed. In 67% of the unprotected patients, the shields were not used at all. In the remainder, the shield was incorrectly applied. Out of all the patients, 45% had more than one X-ray thus exposing the gonads to unnecessary radiation. In addition, 8% of patients had a CT scan, 6% had fluoroscopy and 42% had radiographs of other regions of the body. Conclusions: Guidelines should be adhered to as far as possible and efforts always be made to decrease radiation exposure. Application of the current guidelines excludes the first X-ray exposure of the female pelvis and of the pelvis of trauma patients from the use of shields, thus adding to the number of the X-rays done without protection.