An Analysis of repeated examinations in conventional film–screen radiography (FSR).

Abstract

Background: X-ray is an ionising form of radiation used in
conventional radiography and this can result in deleterious biological
changes in the body if not regulated. Radiation safety is an important
practice in a medical facility that utilizes radiation in any form for
diagnosis, intervention or treatment. Repeat of non-diagnostic
radiographs add to the radiation received by the patient and the
personnel. The committee on quality assurance in diagnostic X-ray
recommended a repeat rate of 5 – 7% or less.
Purpose: The purpose of this study was to determine image repeat
rate and the causes of repeat in a University Teaching Hospital.
Materials and Methods: It was a prospective study involving all
routine radiographic cases in department over a two month period
during which 1251 examinations were carried out. Radiographs were
assessed for diagnostic quality by Radiologists following the usual
clinical protocols in radiology film review. The number of
radiographs in each examination type which did not meet diagnostic
criteria and therefore required repeat, were isolated and counted.
Results are presented in simple percentages.
Results: The overall repeat rate was 8.6%. The highest repeat rate
was observed in radiographs of the lumbosacral region (53.06%) and
the lowest rate in the leg (2%). Under-exposure was the leading
cause of repeat (41.67%), while film fog was the least cause
(0.93%). Inappropriate selection of exposure factors and poor patient
positioning by radiographers who are mainly interns (n=8) and
junior radiographers (n=4) contributed most to the repeats. Patient
faults or poor darkroom practice were the other reasons for repeats.
Conclusion: The rate of repeat is above the accepted limits
recommended by the committee on quality assurance in diagnostic
X-ray (5 – 7% or less). It has increased above the 4% previously
obtained (1992 assessment). The rate can be reduced if the junior
cadre radiographers are better supervised and a quality assurance
program instituted.