Medical X-ray imaging has led to improvements in the diagnosis and treatment of numerous medical conditions in paediatric patients. The Federal Food, Drug, and Cosmetic Act (FD&C Act) defines paediatric patients as persons aged 21 or younger at the time of their diagnosis or treatment.

Typically, these are broken down into different groups based on age ranges (neonates, infants, children, and adolescents). For medical X-ray imaging, the paediatric patient’s size is even more important to consider than age, because patient size determines how much radiation is needed to produce a quality medical image.

The individual risk from X-ray imaging is small when compared to the benefits it can provide through helping with accurate diagnosis. Still, efforts should be made to minimise risk by reducing unnecessary exposure to ionising radiation. This is important because: paediatric patients are more radio-sensitive than adults (that is, the cancer risk per unit dose of ionising radiation is higher); use of equipment and exposure settings designed for adults may result in excessive radiation exposure if used on smaller patients; paediatric patients have a longer expected lifetime, putting them at higher risk of cancer from the effects of radiation exposure.

The FDA recommends that medical x-ray imaging exams, which include computed tomography (CT), fluoroscopy, and conventional X-rays, use the lowest radiation dose necessary, taking into account the size and age of the patient.

Whether grouped by age or by size, an X-ray image should always be adjusted to meet the needs of the specific type of paediatric patient receiving the exam.

X-ray exams should be performed for children only when the child’s physician believes they are necessary to answer the clinical question or to guide treatment.

Source: USFDA

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