A Quality Improvement Initiative to Reduce Radiation Dose During Cast Treatment for Infantile Scoliosis

Khoury, Joseph G.; Lawing, Cheryl; Maciel, Maureen; Achors, Kyle; Fontenot, Phillip

doi:10.55275/jposna-2020-107

Cited by 1 publication

(2 citation statements)

References 18 publications

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“…This study took place at our Pediatric Orthopaedic Specialty Hospital under the direction of three board certified pediatric orthopedic surgeons who treat idiopathic DDH and neuromuscular hip displacement. Based on the success of grid removal in spine radiographs [14], a similar technique was applied to our pelvic radiographs. This research was exempted from IRB approval by WCG IRB (Puyallup, Washington, USA).…”

Section: Methodsmentioning

confidence: 99%

“…Our institution previously investigated removal of the grid from our radiographic technique for obtaining spine radiographs in patients undergoing elongation, extension, and derotational casting for treatment of infantile idiopathic scoliosis. This study demonstrated that inter- and intrarater reliabilities of Cobb angle measurements were not reduced despite an estimated 80% reduction in radiation dose [14]. The purpose of this study was to determine if the radiation dose could be decreased, without compromising measurement accuracy, using a similar radiographic technique change in how AP pelvis radiographs are obtained.…”

Section: Introductionmentioning

confidence: 99%

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Reliability of radiographic measurements for hip dysplasia using a reduced radiation technique

Lawing

Gorbe

Maciel

et al. 2022

Journal of Pediatric Orthopaedics B

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The purpose of this study was to examine whether measurement accuracy is impacted with a low radiation radiograph technique. Treatment decisions for hip dysplasia require serial radiographs to monitor acetabular anatomy. However, radiation use creates concern for future malignancy. Standard radiograph technique utilizes a grid to enhance clarity, but requires a larger X-ray dose. We hypothesized grid removal would lower radiation exposure without decreasing measurement accuracy. This is a retrospective cohort study of patients with idiopathic DDH and neuromuscular hip displacement at a single institution from 2019 to 2020 receiving surveillance radiographs. A cohort receiving modified technique radiographs (grid removed) was compared to an age-matched cohort receiving standard technique radiographs. Four examiners measured radiographs on two separate occasions, a minimum of 2 weeks apart. Migration percentage (MP) was measured for neuromuscular patients and acetabular index (AI) for idiopathic DDH. Intraclass correlation coefficient (ICC) with a 95% confidence interval (CI) was used to evaluate inter-observer and intra-observer agreement for measurements. Average radiation dose for both techniques. A total of 134 age-matched patients were included for measurement of MP. Thirty age-matched patients were included for AI measurements. Inter and intra-rater reliability of MP and AI were not different with or without use of the grid. There was a 50–75% decrease in radiation dose per radiograph following grid removal, dependent on patient size. The adjusted radiograph technique showed no significant difference in MP or AI reliability. A slight decrease in picture contrast did not jeopardize measurement reliability and decreased radiation exposure for the patient significantly. This simple technique can be useful for patients requiring multiple radiographs over time.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reliability of radiographic measurements for hip dysplasia using a reduced radiation technique

Lawing

Gorbe

Maciel

et al. 2022

Journal of Pediatric Orthopaedics B

View full text Add to dashboard Cite

show abstract

A Quality Improvement Initiative to Reduce Radiation Dose During Cast Treatment for Infantile Scoliosis

Abstract: A p-value < 0.05 was considered statistically significant. This project was undertaken as a quality improvement initiative at Shriners Hospitals for Children and was exempted from formal review by Western IRB.

Cited by 1 publication

References 18 publications

Reliability of radiographic measurements for hip dysplasia using a reduced radiation technique

Reliability of radiographic measurements for hip dysplasia using a reduced radiation technique

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