gonad shielding during x-rays

[leahdragonfly]

Hi everyone,

My daughter had a routine scoliosis x-ray today and I think they may have shielded her incorrectly. It was a PA x-ray (shot back to front, with her facing the x-ray plate and the x-ray beam coming from behind). They taped the shield to her tummy, and were very quick about everything, but later I thought they shielded her from the wrong side! I think they should have placed the shield at her back.

I called the Dr's office where the x-ray was done and spoke to the rad tech. What she told me sounds strange: she said "the main x-ray beam is not harmful at all, it is the scatter that bounces back that is harmful." I know about scatter, but I think the statement "the main x-ray beam is not harmful at all" can not possibly be correct. I asked if this was something new and she said no. So does this sound strange to anyone else?? We have never had x-rays done here before.

I know what's done is done, but any thoughts?

[briarrose]

The shield should have been placed on the other side of her. It's good they usually use shield though since I never have one! Regarding the x-ray beam, I'm surprised by the answer for the main beam not being an issue. I've used x-rays in labs for some of my chemistry classes and we were always told the incident beam is the most harmful. The scatter isn't as harmful because energy is lost. X-rays now are so much safer than they used to be. The amount of radiation from one x-ray is equivalent to about 10 days of normal living radiation. I've also heard that a 10 hour flight gives the same amount of radiation as an x-ray.

Hopefully this won't happen next time!

Shell

[mariaf]

Hi Gayle,

I agree the shield should have been place on the other side of her.

I also was told by Dr. D'Andrea that she always ordered PA x-rays because they were safest.

I hope you get to the bottom of this and find out why you were told differently.

[MRTmum]

This is a cause of arguement amongst health professionals. Different hospitals/clinics have different protocols regarding the 'proper' placement of the gonadal shielding. Our hospital's policy is that if the pt is PA, then the lead faces the tube (source of ray). But I also know of hospitals that place it facing the bucky (away from the tube).

The primary beam (that exiting the tube) is for the most part, high energy and as such will penetrate the pt and exit towards the plate. Those that are lower in energy are absorbed by body tissues.

If a high energy photon exits the pt and is scattered (detoured by something else), energy is lost upon collison. Since it is now low energy, the body will absorb it (therefore increase dose). The idea with the shield facing the board is that it will prevent these lower energy ones from re-entering the pt.

Both arguements sound valid in my opinion, but what I don't get is why don't they just provide one that wraps ALL the way around Lol
Oh well, hopefully they'll figure it out!

~**~ Congenital Scoliosis w associated radial clubhand/thumb aplasia ~**~
*~2 Harrington rods + fusion in 1985 (age 10) by Dr.W Bobechko, Toronto~*
23 yrs post op...have 3 kids, training to be MRT, next to nil pain!
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[leahdragonfly]

Hi MRTmum,

Thanks so much for your reply! I saw your other post yesterday and hoped you would reply to this thread. I have actually called around to several pediatric radiology departments (including Shriners) and asked this question, and I was told that no one seems to agree about the placement of the shield. Most told me they would shield from the primary beam (shield on the back for PA), but some said it was reasonable to shield from the scatter. I asked if it would be unreasonable to insist on shielding on both front and back, and was told this is a reasonable request (I would have insisted anyway, just wanted to be ready if the techs tried to refuse). So from now on, I will insist on front and back shielding for my daughter.

Good luck with your studies. Thanks again for the helpful input. I know I am not alone in worrying about the radiation exposure our scoliosis kiddos are exposed to.