pISSN 2005-9159
eISSN 2093-0569

Review Article

Korean J Pain 2022; 35(2): 129-139

Published online April 1, 2022 https://doi.org/10.3344/kjp.2022.35.2.129

Copyright © The Korean Pain Society.

Radiation safety for pain physicians: principles and recommendations

Sewon Park , Minjung Kim , Jae Hun Kim

Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea

Correspondence to:Jae Hun Kim
Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea
Tel: +82-2-2030-5749
Fax: +82-2-2030-5449
E-mail: painfree@kuh.ac.kr

Handling Editor: Kyung Hoon Kim

Received: November 23, 2021; Revised: February 12, 2022; Accepted: February 13, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


C-arm fluoroscopy is a useful tool for interventional pain management. However, with the increasing use of C-arm fluoroscopy, the risk of accumulated radiation exposure is a significant concern for pain physicians. Therefore, efforts are needed to reduce radiation exposure. There are three types of radiation exposure sources: (1) the primary X-ray beam, (2) scattered radiation, and (3) leakage from the X-ray tube. The major radiation exposure risk for most medical staff members is scattered radiation, the amount of which is affected by many factors. Pain physicians can reduce their radiation exposure by use of several effective methods, which utilize the following main principles: reducing the exposure time, increasing the distance from the radiation source, and radiation shielding. Some methods reduce not only the pain physician’s but also the patient’s radiation exposure. Taking images with collimation and minimal use of magnification are ways to reduce the intensity of the primary X-ray beam and the amount of scattered radiation. It is also important to carefully select the C-arm fluoroscopy mode, such as pulsed mode or low-dose mode, for ensuring the physician’s and patient’s radiation safety. Pain physicians should practice these principles and also be aware of the annual permissible radiation dose as well as checking their radiation exposure. This article aimed to review the literature on radiation safety in relation to C-arm fluoroscopy and provide recommendations to pain physicians during C-arm fluoroscopy-guided interventional pain management.

Keywords: Fluoroscopy, Pain, Procedural, Radiation, Radiation Dosage, Radiation Effects, Radiation Exposure, Radiation, Ionizing, Radiography, Interventional, Radiology, Interventional, Safety, Scattering, Radiation, X-Rays.