Radiation Exposure in Patients with Isolated Limb Trauma: Acceptable or Are We Imaging Too Much?

Abstract

The aim of our study was to investigate the cumulative effective dose of radiation resulting from medical imaging in orthopaedic patients with isolated extremity trauma. Deidentified radiology records of consecutive patients without age restriction with isolated extremity trauma requiring operative treatment at a regional hospital were reviewed retrospectively over a 1-year period, and the effective dose per patient for each study type of plain film X-ray, computed tomography, and operative fluoroscopy was used to calculate cumulative effective dose. Values were summarised as mean, ± standard deviation, maximum, and proportion with overdose (>20 mSv). The study cohort included 428 patients (193 male and 235 female) with an average age of 44 years (±28). There were 447 procedures performed, i.e., all involved operative fluoroscopy, 116 involved computed tomography, and 397 involved X-ray. The mean cumulative effective dose per patient was 1.96 mSv (±4.98, 45.12). The mean cumulative effective dose for operative fluoroscopy was 0.32 mSv (±0.73, 5.91), for X-ray was 1.12 mSv (±3.6, 39.23) and for computed tomography was 2.22 mSv (±4.13, 20.14). The mean cumulative effective dose of 1.96 mSv falls below the recommended maximum annual exposure of 20 mSv. This study can serve as a guide for informing clinicians and patients of the acceptable radiation risk in the context of isolated extremity trauma.

Advantages of CT Versus MRI for Preoperative Assessment of Osteochondritis Dissecans of the Capitellum

“…The radiation dose of an elbow CT is about 7% of the average background radiation exposure for an individual (3 mSv/y) and about 10 times more than one experiences during a 7-hour flight on an airplane (0.02 mSv). 5,16,28 We believe that the advantages of CT in capitellar OCD justify the moderate radiation exposure with regard to the young age of the study population. Furthermore, the additional information obtained from CT plays an important role in surgical planning and preparation.…”

“…The higher detection rate for CT comes at the cost of a higher radiation exposure, about 0.21 mSv (CT with the arm above the head), 14 compared with 0.01 mSv for plain radiography of the elbow 28 and no radiation exposure for MRI. The radiation dose of an elbow CT is about 7% of the average background radiation exposure for an individual (3 mSv/y) and about 10 times more than one experiences during a 7-hour flight on an airplane (0.02 mSv).…”

Radiation dose assessment to patients undergoing radiological X-ray procedures of upper extremity

“…This is a retrospective study, which included all adult patients of any age who presented to the Radiology Department (RD) with an upper extremity injury at a referral hospital in Kebbi [3] . The materials used in this research work are conventional X-ray machine with build control panel which comprises of exposure parameters (such as kVp, and mAs), erect Bucky, CR cassettes which are of different sizes base on the type of body part to be expose.…”

“…The goal of radiation protection is to prevent or minimize exposures that have no benefit; therefore, so patient dose measurement is essential in radiation protection and quality assurance programs. Radiologists constantly face the dilemma of trying to minimize patient exposure whenever possible, while still using exposures that are high enough to produce images of good enough quality as to be able to provide a proper diagnosis [2][3][4] .…”

Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds

“…[93] e median radiation dose in patients who underwent wholebody CT scans is 34-40.2 mSv, equivalent to 680 chest radiographs. [94,95] Sharma et al reported a mean exposure of 14.56 mSv to all the patients within 24 h of their admission to the trauma center. [96] e lifetime risk of cancer for a 100 mSv exposure is 1 in 100.…”