Fluroscopy in paediatric fractures - Setting a local diagnostic reference level

Background: The ionizing radiations (Medical Exposure) Regulation 2000 has made it mandatory to establish diagnostic reference levels (DRLs) for all typical radiological examinations. Objectives: We attempt to provide dose data for some common fluoroscopic procedures used in orthopaedic trauma that may be used as the basis for setting DRLs for paediatric patients. Materials and methods: The dose area product (DAP) in 865 paediatric trauma examinations was analysed. Median DAP values and screening times for each procedure type along with quartile values for each range are presented. Results: In the upper limb, elbow examinations had maximum exposure with a median DAP value of 1.21 cGy cm(2). Median DAP values for forearm and wrist examinations were 0.708 and 0.538 cGy cm(2), respectively. In lower limb, tibia and fibula examinations had a median DAP value of 3.23 cGy cm(2) followed by ankle examinations with a median DAP of 3.10 cGy cm(2). The rounded third quartile DAP value for each distribution can be used as a provisional DRL for the specific procedure type.