Thiings To Consider Before Your Child Gets An X-ray

     There are times when a child needs an X-Ray but there are many more times when unnecessary X-rays are done. X-ray examinations cause exposure to radiation that accumulates over a child’s lifetime and causes an increased risk of cancer with every exposure. A child’s body is also more susceptible to the effects of radiation.

     Unnecessary X-ray studies are done for many reasons, but they are often done to confirm a diagnosis that can be made by physical examination alone. Often, the parents are the ones who insist on the study being done and the doctor complies because of the risk of a lawsuit. The child hits his head and may even have a mild concussion. The doctor can explain to the parents about the signs of an internal hemorrhage and instruct them on what to watch for but the parents often want a CAT scan “to be sure”. The doctor may not feel the CAT scan is necessary, but will get it to avoid “missing” a small hemorrhage. A CAT scan is now routinely done to diagnose appendicitis before any surgeon will agree to operate.  The frequent use of CAT scans in children is especially worrisome because CAT scans involve much higher doses of radiation than regular X-rays. Fluoroscopy also involves more radiation than standard X-rays and should only be done when absolutely necessary. Even with regular X-rays, doses of radiation designed for adults are often used when much lower doses would be sufficient for children.

     A doctor may get an X-ray of a fractured clavicle (collar bone) even though the history and physical exam clearly make the diagnosis and there is no treatment necessary. A doctor may make the diagnosis of pneumonia in a child who is not in any respiratory distress but feel an X-ray is necessary “to be sure”.  Again, with proper instruction on what symptoms to observe for, the X-ray doesn’t change either the diagnosis or the treatment.

     The FDA has recently asked manufacturers of imaging devices to create new machines designed specifically with children in mind. Radiology departments are developing protocols designed for children with smaller doses of radiation and limited areas of body exposure. Parents need to discuss the advantages and disadvantages of any X-ray with their doctor. They should always ask: “Is the result of the X-ray going to change the way we are going to treat the problem?”; “If we watch the child closely for any developing symptoms, can we hold off doing the X-ray as long as we agree to get it if the situation changes?” 

     An X-ray examination is simple and can be reassuring, but parents and physicians need to always consider the risk and ask if the study is necessary.