Gonadal shields in pelvic radiographs in pediatric patients.

We performed a retrospective study of pelvic radiographs of children between August 2003 and January 2004 to determine whether gonadal shields effectively protected the gonads during pelvic radiographs in pediatric patients. We considered 1,047 radiographs of 111 children under the age of 16 years who were examined by the orthopaedic department at the University Hospital of North Staffordshire. The presence and absence of gonadal shields in all the pelvic radiographs was recorded. If the shields were present, then whether the gonads were effectively protected was recorded. An average of 9.4 radiographs were taken per patient. The gonadal shields effectively protected the gonads in 466 (49.2%) radiographs and were completely omitted in 270 (28.5%) radiographs. In the remaining 212 (22.3%) radiographs, the shields did not adequately protect the gonads, which were therefore exposed to radiation in 482 (50.8%) of all the eligible pelvic radiographs. Children receive many radiographs with avoidable excess radiation from inadequate positioning or complete omission of gonadal shields. This may increase the potential for disease in the future offspring of these patients. Strict adherence to guidelines is required to decrease radiation exposure.