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X-Rays, Scans, Radiation, and Kids

What Parents Need to Know Before the Doctor or Dentist Orders a Scan
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WebMD Feature

When a child is ill or injured, you want your child to get whatever medical tests are needed, as soon as possible.

But when it comes to imaging tests -- such as X-rays, PET scans, and CT scans -- the key word is "needed."

Those tests use radiation that, if exposed to often enough, has been linked to a greater chance of getting cancer later in life. And because kids are still growing, they're more sensitive to radiation.

"No patients should be exposed to more radiation than they need at any age," says pediatric radiologist Marta Hernanz-Schulman, MD, chair of the American College of Radiology's Pediatric Imaging Commission.

No doubt: X-rays and scans can be helpful, even life-saving. But sometimes, they're not necessary.  

So when are these tests really needed? Here's what you should know.

Too Much Testing?

The average child now gets seven scans that rely on radiation before age 18, one recent study shows.

Most of those tests are X-rays, which use relatively low levels of radiation. About one in eight scans ordered for kids is a CT scan.

Because they spin around the body taking multiple images, CT scans can deliver radiation doses that are up to 200 times higher than an average chest X-ray.

About 7 million CT scans are done on U.S. kids each year. And that number is rising about 10% per year.

Why? Pediatric surgeon Thomas Pranikoff, MD, of Brenner Children's Hospital in Winston-Salem, N.C., has studied that.

He says it's partly about doctors' use of technology. "People aren't focusing as much on clinical skills like taking a patient's history and doing a physical examination," he says.

It's also about parents demanding tests. "They want an answer right away and that puts a lot of pressure on the doctors taking care of them," Pranikoff says.

Sometimes kids don't need a scan at all. They just need to be watched in a safe setting.

One study showed that kids who went to an ER after suffering a minor head injury were less likely to get a CT scan if they were simply observed in the ER for 4-6 hours -- and that observation period didn't compromise their safety.  

What Are the Risks?

You may have heard about a study showing that kids who have two to three CT scans were nearly three times as likely to develop a brain tumor or leukemia in the decade following their first scan, compared to children who were not scanned.  

But you should know that it's very unlikely that a child will develop a brain tumor or leukemia -- scan or no scan. The odds that a child will develop a brain tumor or leukemia are very low to begin with, and they're still low, even if that number triples.

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