Pediatric patients are especially sensitive to radiation exposure from medical imaging, potentially increasing their risk for cancer. An analysis presented at the American Academy of Orthopaedic Surgeons, 2017 Annual Meeting in March provides recommendations aimed at reducing unnecessary exposure.
Senior research author David H. Godfried, MD, clinical associate professor of orthopaedic surgery and pediatrics and director of the Center for Children at NYU Langone’s Hospital for Joint Diseases, and colleagues developed the following best practices: Follow the ALARA (as low as reasonably achievable) principle to limit exposure to parts of the body that are absolutely essential for diagnosis; eliminate repeated exposures resulting from technical errors; limit precise collimation to the region of interest; and limit fluoroscopy to short bursts as needed.
Additional guidelines recommended by the authors include: use low-dose CT protocols adjusted for the size of the patient; limit CT of the spine and pelvis in pediatric patients; female patients are more susceptible to adverse effects than male patients; scoliosis patients should have limited follow-up x-rays; leg length, scoliosis, and hip dysplasia (anteversion) studies should utilize EOS imaging technology rather than traditional x-rays; x-rays are an acceptable diagnostic tool for extremities, such as the wrist, ankle, etc.; and CT scans are an acceptable diagnostic tool for triplane fractures.