If you want to reduce the odds of a child getting an X ray and being

exposed needlessly to radiation, take them to a children's hospital. That's

the upshot of a recent study that looked at children who had been

evaluated for appendectomies at a children's hospital as compared with a

general hospital.

When kids get diagnosed with appendicitis,

often it's via X rays — specifically, CT scans. But CT scans expose

children to more radiation than many doctors would like.

There is one solution: ultrasounds. The

problem is most children won't get those unless they go to a children's

hospital, and ultrasounds also require a lot of specialized expertise to

interpret. That's something not a lot of general hospitals will have.

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recent study by the Washington University School of Medicine in St.

Louis, published in the journal Pediatrics, bears this out. If a patient

went to St. Louis children's hospital they were more likely to be

checked with an ultrasound than with a CT scan.

The study covered

423 children who had appendectomies at St. Louis Children's Hospital. Of

the 423, 205 were initially evaluated at general hospitals and 215 at

Children's. Some 85 percent of patients who went to a general hospital

to be evaluated got CT scans before surgery, and 45 percent of children

initially seen at St. Louis Children's Hospital had CT scans. Meanwhile,

over half of children initially seen at St. Louis Children's Hospital

got ultrasounds, while at general hospitals the rate was 20 percent.

Seven percent were not scanned at all and 15 percent got both ultrasound

and CT.

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The authors of the study noted that even though reading

an ultrasound is a bit harder, it's probably worth finding a way to do

them for more patients, especially children. That said, it isn't clear

whether what applies at a children's hospital, with a lot of experts in

diagnosing kids, is transferable to general hospitals. The other factor

is what happened to those patients whose scans, either ultrasound or CT,

ruled out the need for an appendectomy — an important

question to answer is whether they showed symptoms afterwards, needed an

appendectomy later, or were healthy.


the meantime, the takeaway seems to be that if you want to reduce the

odds of a child getting exposed to radiation via an X ray, take them to a children's hospital.

Credit: Pascal Deloche/Godong/Corbis