Call it the X-ray factor.
With kids spending more time playing outside during the summer and fall months, trips to the emergency room for sprained ankles, pulled muscles and broken bones rise. And with them come requests by doctors for the use of internal imaging like X-rays, which subject the patient to radiation. As such, parents need to understand the potential harmful effects of radiation.
In 2009, the President’s Cancer Panel published a controversial report stating cancer caused by environmental exposures had been “grossly underestimated,” specifically citing the overuse of X-rays during childhood as a potential threat. So, if your son has what appears to be a broken arm, do you let doctors take the X-ray? Well, yes and ‘know.’ Just as you need inoculations to prevent disease, doctors need X-rays to diagnose a suspected problem. But they shouldn’t overuse them.
For years I‘ve spoken of the importance of reducing exposure to radiation when it comes to internal imaging. The Food and Drug Administration takes a similar stance — and has recently proposed requiring safety devices that will stop an examination if radiation levels register above the acceptable range.
Here’s a few things to keep in mind about X-rays and internal imaging of children:
• Speak to your physician about your concerns and ask if the X-ray is absolutely needed.
• Ask how many exposures are needed — in most instances, two views at 90 degrees to each other are the minimum number of exposures required to properly evaluate an area, and additional views may not be needed. Taking comparison views of the opposite arm are rarely needed.
• Ask if an MRI or ultrasound — both of which don’t use radiation — can be used as an alternative. Remember, however, that depending on the age of the child, general anesthesia may be needed for an MRI examination.w
• If a child must have an X-ray, ask if the exposure levels are being minimized. Make sure shields are used to protect areas of the body that are not being imaged.
• Do not let the technologist repeat an X-ray because of movement or a “dark image.” Instead, ask to have a radiologist review the image and determine if it truly needs to be repeated.
• Don’t be afraid to ask as many questions as you need until you get answers that satisfy you. Most radiologists and technologists are well versed in radiation and exposure levels.
Even though some considered the Cancer Panel report as fearmongering, public warnings about potential health risks are necessary to increase awareness and ensure appropriate precautionary measures. They are also an incentives to look for and find solutions and alternatives to unnecessarily risky procedures.
Dr. Helene Pavlov is the Radiologist in Chief at Hospital for Special Surgery, an orthopedic hospital that specializes in treating children and adults suffering from bone and joint conditions.
