Frequency of Common Causes of Rejected Conventional X-Rays in a Radiology Department

Abstract

Objective: the present study aims to evaluate the frequency and causes of rejected conventional X-ray examinations in a radiology department, providing baseline data to support quality improvement initiatives, reduce unnecessary radiation exposure, and enhance diagnostic efficiency.

Study Design: A cross-sectional study
Place and Duration of Study: This study was conducted at the Diagnostic Radiology Department Bolan Medical Complex Hospital Quetta from August 2025 to October 2025.

Methods: A cross-sectional study was performed at the Radiology Department, enrolling 92 patients whose traditional chest/abdominal X-ray had been deemed inadequate. Patient characteristics as well as reasons for
rejection, i.e., overexposure, underexposure, inadequate positioning, patient motion, and artefacts were collected using a structured proforma. Statistical analysis was also carried out between demographic characteristics and reasons for rejection, with a p ≤ 0.05 being significant.

Results: The mean age of the participants was 45.6 ± 13.2 years54; with 58.7% males and 41.3% females55 noted there in were significant differences between the male and female groups (Table 1). Overexposure (43.5%) was the most common reason for rejection, followed by underexposure (27.2%), wrong body part placement (15.2%), patient motion artifact (8.7%), and other artifacts (5.4%). There was a strong relationship between gender and exposure errors (p = 0.02–0.03), with males being more likely to be overexposed and females underexposed at higher proportions of the ED/IRLH. Malposition was also more prevalent among the rural (p = 0.04) dwellers.

Conclusion: Over- and under-exposure are still the main reasons for rejection of routine X-ray, and statistically significant differences were noted in gender and locality.