Evaluation of the Prevalence and Utility of Gonad Shielding in Pediatrics Undergoing Pelvic X-Ray

Background: Gonad shielding has been recommended during pelvic x-rays since the 1950s. The popular method of gonad shielding is placement a lead shield in the midline of the pelvis. The aim of this study was to evaluate the prevalence and utility of gonad shielding in pediatrics undergoing pelvic x-rays.Materials and MethodsFollowing study approval, we retrospectively retrieved data from the digital image library of ten radiology depertments of Khuzestan provience-Iran to identify pediatric patients who underwent pelvic x-ray (anteriorposterior [AP] view). All the images were reviewed for the probable evidence of gonad shield. If there was evidence of shielding, the accuracy positioning of the shield was also investigated by a single assistant radiologist.ResultsIn all 1745 pelvic x-rays (942 girls and 803 boys) were identified of which the shield was present in 51 (5.41%) radiographs of girls and 132 (16.43%) radiographs of boys. When a shield was present; the shields has adequate positioning only in 8 (15.68%) radiographs in girls and 59 radiographs in boys. Inaccurate placement and absence of gonad shields were more common in girls than the boys. Due to the shield has concealed the anatomical criteria of the pelvis, retakes of the examination was required in 11 (21.56%) radiographs of girls and 14 (10.6%) radiographs of boys.ConclusionThe current methods of gonad shielding in girls pelvic x-ray was not effective nor is justifiable. We  no longer advocate of gonad shielding during girls pelvic x-ray. However in boys it is controversial and depends on the skill and effort of radiographers.