X-rays should never be given unless there’s a good reason, but researchers at the Mayo Clinic have found that too many children are being given chest X-rays when there’s no benefit to them.
In a news release issued by the Radiological Society of North America, Dr. Ann Packard said, "Chest X-rays can be a valuable exam when ordered for the correct indications. However, there are several indications where pediatric chest X-rays offer no benefit and likely should not be performed to decrease radiation dose and cost." Packard is a radiologist at the Mayo Clinic.
The dangers of radiation are cumulative. That is, exposure to radiation builds up in the body, and problems might not present for decades. So being exposed to the radiation in an X-ray should be carefully considered, especially in young people because the effects of the experience stay with them forever.
Packard and Dr. Kristen B. Thomas, co-author of the study and head of the pediatric division at the Mayo Clinic, reviewed 719 pediatric chest X-ray exams given over a six-year period in inpatient, outpatient and emergency room settings. The patients ranged in age from newborn to 17 years old.
Of the 719 X-rays:
- 377 exams were ordered for chest pain
- 98 for syncope (fainting) or presyncope
- 21 for a general feeling of being unwell or under distress (spells)
- 37 for postural orthostatic hypotension (POTS), a condition in which blood pressure drops suddenly when the individual stands up from sitting or lying down
- 185 for dizziness
- 1 for cyclical vomiting
Eighty-two of the 719 exams were excluded because of congenital or other known heart disease, and other causes.
A key finding was that in nearly 9 in 10 of the nonexcluded patients, the exam did not alter clinical treatment. None of the patients who underwent X-rays for syncope, spells, POTS, dizziness or cyclical vomiting had any finding that affected treatment.
Only about 12 in 100 of the chest X-rays for chest pain were positive, and included respiratory symptoms such as cough, fever or trauma.
Clearly, too many kids are getting too many chest X-rays. "I would like this research to help guide clinicians and deter them from ordering unnecessary exams which offer no clinical benefit to the patient," Packard said in the statement.
If your practitioner wants to give your child a chest X-ray, ask why he or she believes this is the best, or only approach, especially if the patient has no respiratory symptoms. Ask the doctor what he or she expects to learn from the test.
For more information, see our safety tips for radiation exposure, and read our patient safety blog on new guidelines for imaging tests.