Relationship between radiologist training level and radiation exposure for therapeutic hip injections

The aim of this study was to determine the relationship between the level of training of the performing radiologist and patient radiation exposure, as measured by fluoroscopy time (FT) and dose area product (DAP), during fluoroscopic guided hip injections.

This IRB-approved retrospective review of our institutional radiology report database identified all fluoroscopic guided hip injections performed between August 1st, 2012 and May 30th, 2015. Performing radiologists were divided into groups based on their level of training at the time of the procedure: first-year residents (R1), second-year residents (R2), third-year residents (R3), fourth-year residents (R4), staff fellowship trained musculoskeletal radiologists, and non-musculoskeletal radiologists. A mixed effects model was applied, using level of training as an independent predictor to model FT and DAP separately.

There were 20, 19, 18 and 20 residents in the R1, R2, R3 and R4 groups, respectively. There were 5 performers in the non-MSK radiologist group, and 7 in the MSK radiologist group. A total of 1362 hip injection procedures met the inclusion criteria and were included in the analysis. The overall average FT was 26s (±17SD) and overall average DAP was 20.4uGy*m² (±22.3SD). The mixed effects model showed no statistically significant difference between the groups, for FT (p=0.31) and for DAP (p=0.82).

There is no association between radiologist level of training and patient radiation exposure for fluoroscopic hip injections. Resident trainees maintain radiation exposure to patients at levels comparable to their more experienced colleagues.