Repeated Pelvic Radiographs in Infants, After Harness Treatment for Developmental Dysplasia of the Hip, Carry Very Low Radiation Risk

Elizabeth Vogel; Thomas Leaver; Fiona Wall; Ben Johnson; Michael Uglow; Alexander Aarvold

doi:10.1007/s43465-021-00438-x

Repeated Pelvic Radiographs in Infants, After Harness Treatment for Developmental Dysplasia of the Hip, Carry Very Low Radiation Risk

Indian J Orthop. 2021 Jun 30;55(6):1543-1548. doi: 10.1007/s43465-021-00438-x. eCollection 2020 Dec.

Authors

Elizabeth Vogel¹, Thomas Leaver¹, Fiona Wall², Ben Johnson², Michael Uglow³, Alexander Aarvold^{1

3}

Affiliations

¹ Southampton Medical School, Southampton University, Southampton, UK.
² Medical Physics Department, University Hospital Southampton, Southampton, UK.
³ Paediatric Orthopaedics, Southampton Children's Hospital, Southampton, UK.

Abstract

Objective: There are no data on the effect of X-Ray irradiation to the vulnerable pelvic organs of babies during DDH follow-up. This study aims to calculate, for the first time, the radiation exposure to infants during follow-up for DDH harness treatment, and thus quantify the lifetime risk of malignancy.

Methods: Patients who had completed 5 years' follow-up following successful Pavlik harness treatment were identified from the hospital DDH database. The radiation dose was extracted from the Computerised Radiology Information System database for every radiograph of every patient. The effective dose (ED) was calculated using conversion coefficients for age, sex and body region irradiated. Cumulative ED was compared to Health Protection Agency standards to calculate lifetime risk of malignancy from the radiographs.

Results: All radiographs of 40 infants, successfully treated in Pavlik harness for DDH, were assessed. The mean number of AP pelvis radiographs was 7.00 (range: 6-9, mode: 7). The mean cumulative ED was 0.25 mSv (Range: 0.11-0.46, SD: 0.07). This is far lower than the annual 'safe' limit for healthcare workers of 20 mSv and is categorised as "Very Low Risk".

Conclusion: Clinicians involved in the treatment DDH can be re-assured that the cumulative radiation exposure from pelvic radiographs following Pavlik harness treatment is "Very Low Risk". Whilst being mindful of any radiation exposure in children, this study provides a scientific answer that help addresses parental concerns.

Keywords: DDH; Malignancy; Radiation; Risk; X-rays.