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.

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.