This poses a challenge in pediatric radiographic investigations. Obtaining quality radiographs on pediatric patients can be a challenge. Minimizing radiation dose in pediatric imaging is a crucial issue that has been emphasized and reemphasized in recent years1.
Diagnostic radiation overexposure can cause radiation skin reaction and acute radiation sickness. It can also lead to systemic reactions that may lead to disturbances of normal functional processes, such as, radiation pneumonitis. It is known to have carcinogenic effects and genetic effects2. However, it is also to be considered that the dose required to produce genetic or carcinogenic effects are virtually precluded by modern radiographic apparatus and special techniques used in imaging the patients of this age group. Although carcinogenic effects have not been demonstrated from the doses of radiation received with pediatric diagnostic radiography, children with chronic diseases who need repeated radiographic examinations, this is quite a possibility, although remote. However, there is a need to justify the safety requirements and deploy the technical measures to ensure safety in these patients. Currently, these are directed towards reduction of radiation exposure in such patients3. ...
These are justification of any particular radiographic examination by carefully considering the pros and cons of the test which involves adjustment of risk-benefit analysis. A proper training of the radiographers in handling the children can also reduce exposure considerably. Proper protection of the patient in the unexposed areas could also help.
Specific Diseases Caused by Diagnostic Radiation Exposure
Although the benefits of diagnostic ionizing radiation are immense and exceed the risks involved, cumulative exposure can cause increased cancers especially in the pediatric age group. By definition, ionizing radiation contains enough energy to displace electrons and break chemical bonds. X-rays are electromagnetic radiations and consist of photons that can traverse relatively large distances in tissue without interaction. They, however, can indirectly ionize cell molecular components through transfer of energy4. In 1989, Hoffman and colleagues reported a doubling in the incidence of breast cancers in a pilot study of 1030 women who had been repeatedly exposed to diagnostic radiations for evaluation of scoliosis in their childhood and adolescence5. Ronckers and others explored these results further in a US cohort study with a larger sample size, including cases of scoliosis diagnosed before age 20. The average number of examinations per patient was accounted to be 24.7 and the mean cumulated dose to the breast was 0.11 Gy, and mean age of diagnosis of scoliosis was 10.6 years. With a radiographic followup continuing over an average of 40.1 years, it was concluded that this magnitude of exposures has resulted in increased incidence of breast cancers in these groups6. This proves that there is an increased risk of incidence of breast cancers with