Dose-area product measurements in a range of common orthopaedic proceduresand their possible use in establishing local diagnostic reference levels

There is a national drive towards establishing reference doses for radiolog ical procedures with the aim of optimizing patient doses. Furthermore, the establishment of diagnostic reference level doses became a legal requiremen t for all hospitals on 13 May 2000. However, to date there are little publi shed data on patient radiation doses from fluoroscopic procedures during or thopaedic surgery. Data relating to patient dose for 492 patients undergoin g fluoroscopic examinations during a range of surgical orthopaedic procedur es in 1997-1998 have been analysed. Median dose-area product (DAP) readings and interquartile ranges for a variety of common fluoroscopic orthopaedic procedures are presented. In general, the median BAP for procedures on limb s and extremities was quite low (0.04-1.62 Gy cm(2)), with screening times in the range 0.2-2.0 min, whilst for procedures involving the hips and spin e the median DAP was considerably higher (0.4-10.2 Gy cm(2)), although over all screening times were similar, in the range 0.2-1.4 min. Approximate eff ective doses have been estimated. For procedures involving the limbs and ex tremities, the effective dose was generally less than 10 mu Sv, and for pro cedures involving the hips and spine it was found that the effective dose c ould rise to about 1 mSv. Collective doses for each procedure have been cal culated to inform prioritization of procedures for local dose reduction str ategies.