Positional Challenges of the Anteroposterior Pelvic X-Ray: Comparison of Imaging Reject Rates Between Trauma Trolley and Table Bucky.

Introduction: Pelvic x-rays can be conducted on a trauma trolley or conventional table bucky. The aim of this study was to compare the positional challenges and reject rate between pelvic x-ray images taken on a trauma trolley and a table bucky during a 12-month period in an Australian public metropolitan hospital's emergency department and to determine the accuracy rate of anatomical inclusion via a qualitative assessment of pelvic x-rays using a modified Visual Grading Scale (VGS).

Methods: A retrospective clinical audit of pelvic x-ray image reject rates over a 12-month period was conducted for an emergency department at an Australian hospital. Reject rate and anatomical cut-off were compared between images taken on a trauma trolley and a table bucky using independent samples t-test.

Results: A total of 1847 patients who underwent pelvic x-ray examinations were included in the study. The mean reject rate and the first exposure accuracy of pelvis x-rays taken on a trauma trolley were 35.5% and 56.7% respectively, while the mean reject rate and the first exposure accuracy for images taken on a table bucky were 18.8% and 81.8%, respectively (p < 0.01). The superior and lateral anatomy cut-off were the major causes of image rejection for both techniques.

Conclusions: Pelvic x-rays taken on a trauma trolley had a significantly higher reject rate and lower first exposure accuracy compared with those taken on an x-ray table. Future studies could involve implementing strategies to reduce the reject rate of pelvic x-rays taken on trauma trolleys.