Patient Knowledge Regarding Radiation Exposure From Foot and Ankle Imaging

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.