SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

This 2012 Consensus paper reviews the literature on side effects of x-ray exposure in the pediatric population as it relates to scoliosis evaluation and treatment. Alternative methods of spinal assessment and imaging are reviewed, and strategies for reducing the number of radiographs are developed. Using the Delphi technique, SOSORT members developed consensus statements that describe how often radiographs should be taken in each of the pediatric and adolescent sub-populations.

Related collections

Most cited references 49

Record: found
Abstract: found
Article: not found

An objective criterion for scoliosis screening.

W Bunnell (1984)

A specially designed inclinometer has been used to measure one part of the clinical deformity (asymmetry of the trunk) that is seen in scoliosis. This objective measurement provides one good guideline that can effectively determine, in surveys of children, whether or not further orthopaedic evaluation is needed. A minimum significant angle of trunk rotation of 5 degrees was shown by computer-analyzed data from 1,065 patients to be a good criterion for identifying curvatures of 20 degrees or more. The specificity of scoliosis screening in this manner has a projected false-negative rate of 0.1 per cent and a high degree of sensitivity. The method is simple, reliable, and inexpensive. It is easily taught to lay personnel who can be employed in scoliosis screening procedures.

0 comments Cited 76 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Cancer risks from medical radiation.

Elaine Ron (2003)

About 15% of the ionizing radiation exposure to the general public comes from artificial sources, and almost all of this exposure is due to medical radiation, largely from diagnostic procedures. Of the approximately 3 mSv annual global per caput effective dose estimated for the year 2000, 2.4 mSv is from natural background and 0.4 mSv from diagnostic medical exams. Diagnostic and therapeutic radiation was used in patients as early as 1896. Since then, continual improvements in diagnostic imaging and radiotherapy as well as the aging of our population have led to greater use of medical radiation. Temporal trends indicate that worldwide population exposure from medical radiation is increasing. In the United States, there has been a steady rise in the use of diagnostic radiologic procedures, especially x rays. Radiotherapy also has increased so that today about 40% of cancer patients receive some treatment with radiation. Epidemiologic data on medically irradiated populations are an important complement to the atomic-bomb survivors' studies. Significant improvement in cancer treatment over the last few decades has resulted in longer survival and a growing number of radiation-related second cancers. Following high-dose radiotherapy for malignant diseases, elevated risks of a variety of radiation-related second cancers have been observed. Risks have been particularly high following treatment for childhood cancer. Radiation treatment for benign disease was relatively common from the 1940's to the 1960's. While these treatments generally were effective, some resulted in enhanced cancer risks. As more was learned about radiation-associated cancer risks and new treatments became available, the use of radiotherapy for benign disease has declined. At moderate doses, such as those used to treat benign diseases, radiation-related cancers occur in or near the radiation field. Cancers of the thyroid, salivary gland, central nervous system, skin, and breast as well as leukemia have been associated with radiotherapy for tinea capitis, enlarged tonsils or thymus gland, other benign conditions of the head and neck, or benign breast diseases. Because doses from diagnostic examinations typically are low, they are difficult to study using epidemiologic methods, unless multiple examinations are performed. An excess risk of breast cancer has been reported among women with tuberculosis who had multiple chest fluoroscopies as well as among scoliosis patients who had frequent diagnostic x rays during late childhood and adolescence. Dental and medical diagnostic x rays performed many years ago, when doses were presumed to be high, also have been linked to increased cancer risks. The carcinogenic effects of diagnostic and therapeutic radionuclides are less well characterized. High risks of liver cancer and leukemia have been demonstrated following thorotrast injections, and patients treated with radium appear to have an elevated risk of bone sarcomas and possibly cancers of the breast, liver, kidney, thyroid, and bladder.

0 comments Cited 70 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study.

M M Doody, J E Lonstein, M Stovall … (2000)

A retrospective cohort study was conducted in 5573 female patients with scoliosis who were referred for treatment at 14 orthopedic medical centers in the United States. Patients were less than 20 years of age at diagnosis which occurred between 1912 and 1965. To evaluate patterns in breast cancer mortality among women with scoliosis, with special emphasis on risk associated with diagnostic radiograph exposures. A pilot study of 1030 women with scoliosis revealed a nearly twofold statistically significant increased risk for incident breast cancer. Although based on only 11 cases, findings were consistent with radiation as a causative factor. Medical records were reviewed for information on personal characteristics and scoliosis history. Diagnostic radiograph exposures were tabulated based on review of radiographs, radiology reports in the medical records, radiograph jackets, and radiology log books. Radiation doses were estimated for individual examinations. The mortality rate of the cohort through January 1, 1997, was determined by using state and national vital statistics records and was compared with that of women in the general U. S. population. Nearly 138,000 radiographic examinations were recorded. The average number of examinations per patient was 24.7 (range, 0-618); mean estimated cumulative radiation dose to the breast was 10.8 cGy (range, 0-170). After excluding patients with missing information, 5466 patients were included in breast cancer mortality analyses. Their mean age at diagnosis was 10.6 years and average length of follow-up was 40.1 years. There were 77 breast cancer deaths observed compared with the 45.6 deaths expected on the basis of U.S. mortality rates (standardized mortality ratio [SMR] = 1.69; 95% confidence interval [CI] = 1.3-2.1). Risk increased significantly with increasing number of radiograph exposures and with cumulative radiation dose. The unadjusted excess relative risk per Gy was 5.4 (95% CI = 1.2-14.1); when analyses were restricted to patients who had undergone at least one radiographic examination, the risk estimate was 2.7 (95% CI = -0. 2-9.3). These data suggest that exposure to multiple diagnostic radiographic examinations during childhood and adolescence may increase the risk of breast cancer among women with scoliosis; however, potential confounding between radiation dose and severity of disease and thus with reproductive history may explain some of the increased risk observed.

0 comments Cited 70 times – based on 0 reviews      Review now

All references

Author and article information

Contributors

Patrick Knott

Eden Pappo

Michelle Cameron

JC deMauroy

Charles Rivard

Tomasz Kotwicki

Fabio Zaina

James Wynne

Luke Stikeleather

Josette Bettany-Saltikov

Theodoros B Grivas

Jacek Durmala

Toru Maruyama

Stefano Negrini

Joseph P O’Brien

Manuel Rigo

Journal

Journal ID (nlm-ta): Scoliosis

Journal ID (iso-abbrev): Scoliosis

Title: Scoliosis

Publisher: BioMed Central

ISSN (Electronic): 1748-7161

Publication date Collection: 2014

Publication date (Electronic): 25 April 2014

Volume: 9

Page: 4

Affiliations

[1 ]The 2012 SOSORT Conference, Milan, Italy

Article

Publisher ID: 1748-7161-9-4

DOI: 10.1186/1748-7161-9-4

PMC ID: 4002921

PubMed ID: 24782912

SO-VID: d459518b-e117-4c5b-a885-8122089ab705

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis

Read this article at

Abstract

Related collections

Orthopedics

Most cited references 49

An objective criterion for scoliosis screening.

Cancer risks from medical radiation.

Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study.

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Comments

Comment on this article

Similar content 244

Cited by 37

Most referenced authors 427