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Assessing the appropriateness of CT scans among pediatric ortho patients

par Lee Nelson, Contributing Reporter | March 17, 2017
CT Pediatrics X-Ray

Hospital audits of the number of X-rays obtained for pediatric scoliosis patients in a given year may provide data for individual physicians to assess their usage versus local and national norms.

“My experience is that the vast majority of physicians want to do what is best for their patients,” Godfried said.

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The most important lessons learned from this analysis are that child/family and health care providers must work as team. All must acknowledge that patient safety is a priority and that imaging technology used appropriately can improve care, but that current practices need to be reexamined based on nationally accepted best practices, he said.

The research that Godfried and Rahman reviewed included a lot of variation in age and radiation doses.

"Radiation doses generally increase with patient age proportional to the size and weight of the patient,” Rahman told HCB News. “The risk of cancer, however, is increased in younger children compared to older children. The relationship between female patients having twice the risk of adverse events as male patients remains generally constant throughout all age groups. These numbers really highlight the unique susceptibility of younger patients and female patients to radiation exposure."

For example in one finding, female scoliosis patients received two times more X-rays than non-surgical patients, amounting to twice the radiation exposure to the breasts, ovaries and bone marrow. That correlated to an over two percent increased lifetime risk of fatal breast cancer, almost one percent risk of fatal leukemia and three percent risk of genetic defects. Non-surgical patients had approximately half that risk.

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