Patient and Surgeon Radiation Exposure: Comparison of Standard and Mini-C-Arm Fluoroscopy

Giordano, Brian D.; Baumhauer, Judith F.; Morgan, Thomas L.; Rechtine, II, Glenn R.
February 2009
Journal of Bone & Joint Surgery, American Volume;Feb2009, Vol. 91-A Issue 2, p297
Academic Journal
Background: Use of c-arm fluoroscopy is common in the operating room, outpatient clinic, and emergency department. Consequently, there is a concern regarding radiation exposure. Mini-c-arm fluoroscopes have gained popularity; however, few studies have quantified exposure during mini-c-arm imaging of a body part larger than a hand or wrist. The purpose of this study was to measure radiation exposure sustained by the patient and surgeon during the use of large and mini-c-arm fluoroscopy of an ankle specimen. Methods: Standard and mini-c-arm fluoroscopes were used to image a cadaver ankle specimen, which was suspended on an adjustable platform. Dosimeters were mounted at specific positions and angulations to detect direct and scatter radiation. Testing was conducted under various scenarios that altered the proximity of the specimen and the radiation source. We attempted to capture a range of exposure data under conditions ranging from a best to a worst-case scenario, as one may encounter in a procedural setting. Results: With all configurations tested, measurable exposure during use of the large-c-arm fluoroscope was considerably higher than that during use of the mini-c-arm fluoroscope. Patient and surgeon exposure was notably amplified when the specimen was positioned closerto the x-ray source. The exposure values that we measured during ankle fluoroscopy were consistently higher than the exposure values that have been recorded previously during hand or wrist imaging. Conclusions: Exposure of the patient and surgeon to radiation depends on the tissue density and the shape of the imaged extremity. Elevated exposure levels can be expected when larger body parts are imaged or when the extremity is positioned closer to the x-ray source. When it is possible to satisfactorily image an extremity with use of the mini c-arm, it should be chosen over its larger counterpart. Clinical Relevance: Orthopaedists should exercise caution, and consistently follow radiation safety guidelines, when using c-arm fluoroscopes because there is a real risk of radiation exposure.


Related Articles

  • Radiation management and credentialing of fluoroscopy users. Archer, Benjamin R. // Pediatric Radiology;Sep2006 Supplement, Vol. 36, p182 

    During the last 15 years, developments in X-ray technologies have substantially improved the ability of practitioners to treat patients using fluoroscopically guided interventional techniques. Many of these procedures require a greater use of fluoroscopy and more recording of images. This...

  • radiation injury, ionizing.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1962 

    An encyclopedia entry for "radiation injury, ionizing," which refers to cell and intracellular molecule damage caused by x-rays, gamma rays or other sources of radioactive energy, is presented.

  • Image Conscious. Meyer, Charles R. // Minnesota Medicine;Dec2009, Vol. 92 Issue 12, p4 

    An introduction to the journal is presented in which the editor discusses an article on fellowship doctors doing the work of surgeons, the carcinogenic effects of X-rays, and the possible danger of prenatal ultrasound to the fetus.

  • Untitled. Rivers, Francis // Nutrition Health Review: The Consumer's Medical Journal;1993, Issue 66, p4 

    Discusses several medical news and health issues affecting man. Health effects of x-ray; Studies supporting the relationship between cancer and electromagnetic radiation; Effects of radiation on epileptic seizures. INSET: Measuring device available..

  • What are the Intracellular Targets and Intratissue Target Cells for Radiation Effects? Hamada, Nobuyuki // Radiation Research;Jan2014, Vol. 181 Issue 1, p9 

    Exactly a century after Röntgen's discovery of X rays, I entered a university to major in radiological sciences. At that time, I felt that, despite extensive use and indispensable roles of ionizing radiation in medicine and industry, many fascinating questions have yet to be answered...

  • Microbeams in radiation biology: review and critical comparison. Prise, K. M.; Schettino, G. // Radiation Protection Dosimetry;Feb2011, Vol. 143 Issue 2-4, p335 

    Microbeams have undergone a renaissance since their introduction and early use in the mid-60s. Recent advances in imaging, software and beam delivery have allowed rapid technological developments in microbeams for use in a range of experimental studies. Microbeams allow the effects of single...

  • Effects of Low Level X Radiation on the Mitotic Index of Hamster Basal Epithelial Cells In Vivo. LURIE, ALAN // Journal of Dental Research;Nov1969, Vol. 48 Issue 6, p1049 

    Chinese hamster cheek pouches were exposed to low doses of X radiation and to two doses of a metaphase arrester, vinblastine sulfate, in separate experiments. There was no significant decrease in the mitotic indexes of the irradiated animals. The higher vinblastine dose proved to be...

  • radiation hazards. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p644 

    An encyclopedia entry for "radiation hazards" is presented. It refers to hazards brought about by radiation as a result of either external sources of radiation, such as X-rays or gamma rays. Limiting exposure to radiation is cited as a way to control radiation damage. Shielding reproductive...

  • The Genetic Risk in Mice from Radiation: An Estimate of the Mutation Induction Rate per Genome. Asakawa, Jun-ichi; Kodaira, Mieko; Cullings, Harry M.; Katayama, Hiroaki; Nakamura, Nori // Radiation Research;Mar2013, Vol. 179 Issue 3, p293 

    Restriction Landmark Genome Scanning (RLGS) is a method that uses end-labeled 32P NotI sites that are mostly associated with coding genes to visualizes thousands of DNA fragments as spots in two-dimensional autoradiograms. This approach allows direct detection of autosomal deletions as spots...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics