The use of a radiolucent template to improve bone age X-ray quality (BASIC study)

Area of Science:

• Radiology
• Pediatric Endocrinology
• Skeletal Development

Background:

• Left hand and wrist X-rays are standard for skeletal maturity assessment using methods like Tanner-Whitehouse 3 (TW3).
• Poor X-ray quality due to hand positioning difficulties is a common issue.
• A radiolucent hand template was introduced to improve hand positioning and assess its impact on X-ray quality and repeat rates.

Purpose of the Study:

• To evaluate the effectiveness of a radiolucent hand template in improving the quality of bone age X-rays.
• To determine if the template reduces the need for repeat X-rays.

Main Methods:

• Prospective scoring of finger, thumb, and overall clarity of bone age X-rays using a 1-3 scale (poor, borderline, good).
• Introduction of a radiolucent hand template for the intervention group.
• Assessment of repeat X-ray rates based on predefined criteria.

Main Results:

• The intervention group showed improved positioning scores for fingers (89.29%), thumb (98.21%), and overall clarity (76.79%) compared to the control group.
• No repeat X-rays were needed in the intervention group (n=56), versus 28 in the control group (n=259).
• The difference in scores between groups was not statistically significant (p>0.05), but the reduction in repeat X-rays was significant (p=0.007).

Conclusions:

• Obtaining high-quality bone age X-rays is more challenging than anticipated.
• The use of a radiolucent hand template effectively improves hand positioning.
• The template significantly reduces the requirement for repeat bone age X-rays, enhancing efficiency and patient care.