Although estimates vary a CT scan of the chest is equal to several hundred chest X-rays. Due to their age and the sensitivity of their developing organs children are more vulnerable than adults to radiation. A dose of radiation that does not harm an adult can place a child at an increased lifetime risk for cancer. Another issue concerns CT accessibility. CT scans have been available for many years but now they are much faster than in the past. Consequently, when a CT scan was ordered in the past sedation was often needed. Today, distraction is often successful and this is a smaller roadblock to obtaining a CT. Two areas where CT scans are frequently obtained and are unnecessary are for minor head injury and for abdominal pain.
Many children who experience a head injury and are seen in an emergency room do not need to have a head CT done. they can be managed by taking a careful history, performing a thorough exam and providing close follow-up. Although a parent may be reassured by the normal result the reassurance does not justify the radiation their child is exposed to.
Another situation concerns the use of an abdominal CT scan in the diagnosis of appendicitis in children. Although CT scans are very good at making the diagnosis of appendicitis clinical diagnosis and the use of other non-radiation tests such as ultrasound can be very successful in the diagnosis and CT scans can be used on a limited basis depending on clinical course and examination findings.
CT scans are also frequently obtained to evaluate children who have their first seizure. In this situation as in the above examples the most important determinant of whether a CT actually needs to be obtained is the history and physical examination. If the history and physical examination do not point to structural problem with the brain a CT scan is not needed.
What should you do as a parent? Ask questions and listen to the answers. If you feel a CT is being done for reasons that do not justify the risk discuss your concerns with your child’s doctor. Almost always such a discussion will allow your child to receive the best care possible. If there is justification to do the test then do it. If not, seek more advice and another opinion. As always, trust yourself and trust your doctor.