How can physicians reduce radiation exposure in pediatric orthopedic patients? 5 key observations & tips

Practice Management

Researchers from New York City-based NYU Langone Hospital for Joint Diseases have researched the best practices to reduce radiation exposure in children and are presenting their findings at the AAOS 2017 Annual Meeting in San Diego.

Here are five things to know:

 

1. Pediatric patients' increased susceptibility to radiation exposure caused by medical imaging raises their risk to develop cancer later in life.

 

2. Senior research author David H. Godfried, MD, of the Center for Children at NYU Langone's Hospital for Joint Diseases said, "A CT scan may be absolutely necessary for a child. But whenever there is an option, physicians should choose to obtain this information another way."

 

3. Researchers analyzed the amount of radiation in X-ray and CT scans of the spine, pelvis, hip, knees, shoulder, elbow, hand, wrist, foot and ankle.

 

4. Evidence suggested orthopedic surgeons practice the following:

 

  • Follow the "as low as reasonably achievable" principle to strictly limit exposure and collimation to parts of the body that are most essential for diagnosis
  • Eliminate technical errors to reduce repeated exposures
  • Limit fluoroscopy to necessary short bursts
  • Use low-dose CT protocols depending on the patient's size
  • Limit spine and pelvis CTs in pediatric patients
  • Female patients are more prone to negative effects than male patients
  • Limit follow-up X-rays for scoliosis patients
  • Rely on EOS imaging technology instead of traditional X-rays for leg length, scoliosis and hip dysplasia
  • It is acceptable to utilize X-rays as a diagnostic tool for wrists, ankles and other extremities
  • It is acceptable to utilize CT scans as a diagnostic tool for triplane fractures

 

5. NYU Langone Orthopaedic surgeons reduced radiation in CT scans for joint fractures with one-fourteenth the amount of normal CT radiation without compromising image quality or a surgeon's ability to diagnose injuries.

 

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