Concerns About Radiation Exposure from X-rays in Young Children

I took two X-rays of my hip joints to check for internal rotation issues and I'm concerned about radiation exposure?

Hello, doctor.
My 2-year-old child has a slight inward walking pattern that sometimes appears and sometimes does not.
We visited the orthopedic department at National Taiwan University Hospital, where the doctor examined the walking posture and recommended X-rays.
When we arrived at the radiology department, we learned that two X-ray images of the hip joints were required.
During the imaging process, my child was not wearing a protective gown.
I'm relieved that the child's bones are normal and there are no issues, but I'm worried about whether the two X-ray exposures could cause any harm to the body, especially since there was no protection.
I keep regretting why we couldn't communicate more calmly or assess the necessity of the X-rays.
I'm not clear on the amount of radiation exposure from a single X-ray, and there were no protective measures for critical areas of the body.
Is this a normal procedure? As a concerned mother, I wonder if radiation is particularly harmful to young children.
Thank you, doctor.

Bao Ma, 30~39 year old female. Ask Date: 2020/10/14

Dr. Wang Yifen reply Radiology

On April 2, 2019, the American Association of Physicists in Medicine (AAPM) issued a position statement recommending the cessation of the use of patient gonadal and fetal shielding in routine X-ray diagnostic imaging.
This is due to the potential for such shielding to obscure organ structures or interfere with the automatic exposure control of imaging systems, which may lead to an increased radiation dose for patients.
Therefore, with current imaging technology, the use of protective shields (lead aprons) is not advised.

It is important to follow your physician's instructions regarding radiation-related examinations, as the health benefits outweigh the risks associated with radiation exposure.
It is also advisable to keep a record of children's radiation exposure data.
If there are concerns about future radiation examinations, patients should communicate with their physicians before proceeding.
Avoiding examinations out of fear of radiation can lead to missed opportunities for disease treatment.
For more information on radiation, it is recommended to refer to the Atomic Energy Council of Taiwan's public resources on understanding radiation.

Wishing you safety and health.

Reply Date: 2020/10/14

More Info

Hello! Your concerns about radiation exposure from X-rays in young children are completely valid and shared by many parents. Understanding the implications of X-ray exposure, especially in children, is crucial for making informed decisions regarding their healthcare.

Firstly, it’s important to recognize that X-rays are a valuable diagnostic tool used to identify various medical conditions. The amount of radiation exposure from a typical X-ray is relatively low. For instance, a standard X-ray of the hip may expose a child to approximately 0.1 to 0.2 millisieverts (mSv) of radiation. To put this in perspective, the average person is exposed to about 3 mSv of background radiation from natural sources each year. Therefore, the radiation from a couple of X-rays is quite minimal compared to the annual background exposure.

However, children are indeed more sensitive to radiation than adults. Their bodies are still developing, and they have a longer life expectancy, which increases the potential for radiation-induced effects to manifest later in life. The International Commission on Radiological Protection (ICRP) has noted that the risk of developing cancer from radiation exposure is higher in children, particularly for certain sensitive organs such as the thyroid and reproductive organs.

In your case, while the two X-rays taken of your child's hips may not pose a significant risk, it is understandable to feel anxious about the lack of protective measures like lead aprons. Protective gear is typically used to shield sensitive areas from unnecessary radiation exposure, especially in adults. However, in many clinical settings, particularly for lower-dose X-ray procedures, the use of such protective measures may not always be standard practice, especially if the medical staff believes the benefits of the imaging outweigh the risks.

It’s also worth noting that the cumulative effect of radiation exposure is a concern. While a single X-ray may not pose a significant risk, repeated exposures can add up over time. This is why it’s essential to have open communication with healthcare providers about the necessity of each imaging study. Parents should feel empowered to ask questions such as: “Is this X-ray necessary?” or “Are there alternative imaging methods that do not involve radiation?”
In your situation, it’s commendable that you are reflecting on the decision to proceed with the X-rays. Moving forward, it may be beneficial to keep a record of your child's imaging history. This can help you and your healthcare providers make informed decisions about future imaging needs. Additionally, discussing any concerns with your child's doctor can provide reassurance and clarity regarding the necessity and safety of recommended procedures.

In conclusion, while the radiation exposure from the two X-rays is unlikely to cause harm, your feelings of concern are understandable. It’s essential to maintain a dialogue with your healthcare providers about the risks and benefits of imaging studies, especially for young children. By doing so, you can ensure that your child receives the best possible care while minimizing unnecessary exposure to radiation. Remember, the goal of medical imaging is to provide accurate diagnoses that lead to effective treatments, and your proactive approach to your child's health is commendable.

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