Responsible doctors are worried that children can get way too much radiation exposure when they are tested for common problems in the emergency room. X-rays can have great benefit in diagnosing what's wrong, but they can also pose serious long-term risks of cancer from accumulated unnecessary testing.
The main culprit is the CT scanner. Parents need to know that CT scans send out X-ray beams. The typical CT study doses a patient with the equivalent of many dozen chest X-rays.
Ultrasound, by contrast, uses sound waves, so there's no exposure to potentially harmful radiation.
Smart parents sometimes mistakenly push for a CT scan because it's the fanciest and therefore "best" technology. But that's not always true. Ultrasound has now replaced CT as the first-line choice for imaging the abdomen to see if a kid with severe pain might have an inflamed appendix.
A group of doctors just published an article they titled An Appeal for Safe and Appropriate Imaging of Children, in the Journal of Patient Safety. They used as a case study a true story of an 11-year-old girl with abdominal pain who wound up getting two CT scans and scaring her parents to death, all because of a benign nodule found as an "incidental finding" in the lung. She should have received an ultrasound and no CT.
This child has already received an estimated ~20 mSv, which carries with it an increased cancer risk of approximately 1 in 500. Stories like this likely occur every day in the United States.
This unfortunate sequence of patient harm, waste, and needless anxiety could have been completely avoided with the Ultrasound First policy being used at many centers.
We've written before about how doctors are worried about overuse and misuse of radiation imaging. Parents need to know about the issue and work with medical professionals to get their sick and injured children the right imaging test and not necessarily the most high-tech one.