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Patients overestimate radiation from foot and ankle imaging. Most patients believed foot X-rays and CT scans had similar radiation to chest X-rays, contradicting actual lower exposure levels.

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Medical Physics

Background:

  • Diagnostic imaging, including X-rays and CT scans, is frequently used in foot and ankle surgery.
  • Patient understanding of ionizing radiation exposure from these common procedures is not well-established.
  • Concerns exist regarding patient comprehension of radiation doses and their potential risks.

Purpose of the Study:

  • To assess patient understanding of radiation exposure from common foot and ankle diagnostic imaging.
  • To compare patient perceptions with established radiation dose values.
  • To evaluate the extent of pre-procedural discussions about radiation between physicians and patients.

Main Methods:

  • A prospective questionnaire survey was administered to 841 new patients undergoing foot and ankle evaluations.
  • Patients compared perceived radiation doses of foot/ankle imaging (X-ray, cone-beam CT, traditional CT) to chest X-rays (CXRs).
  • Survey responses were compared against published radiation exposure data (in CXR equivalents).

Main Results:

  • Most patients (60.6% with bachelor's degree or higher) incorrectly believed foot X-rays, ankle X-rays, and both types of CT scans had radiation levels similar to CXRs.
  • Actual radiation exposure equivalents were significantly lower: 0.006 for foot X-ray, 0.006 for ankle X-ray, 0.127 for cone-beam CT, and 0.833 for traditional CT.
  • Fewer patients considered radiation before CT scans (46.1%) than X-rays (55.9%), and physician discussions were infrequent (27.6% for CT, 35.2% for X-ray).

Conclusions:

  • Patients significantly overestimate radiation exposure from foot and ankle imaging, particularly plain films and cone-beam CT.
  • Enhanced patient counseling on the relatively low radiation doses is warranted.
  • Improving patient education can alleviate unnecessary concerns about radiation from essential diagnostic imaging.