How to Reduce Radiation Exposure in the Follow-up of Patients with Scoliosis | Chapter 14 | Highlights on Medicine and Medical Research Vol. 11

 During their development, scoliosis patients are subjected to several x-ray investigations. While the need for x-rays during routine check-ups when clinical measurements are taken can be minimised (ATR, Surface Topography), the sensitivity of children and adolescents with scoliosis cannot be prevented because indications and check-ups also depend on the measurement of the Cobb angle on a complete standing x-ray. As a result, it would make sense to greatly minimise this patient group's exposure to radiation. The reduction of exposure is one way to minimise radiation.

The reduction of the diagnostic area is the other choice. The aim of this study was to see whether a single 45 x 45 cm detector from a DR device could be used to diagnose and follow up on adolescent girls with scoliosis.

Materials and Methods: A total of 32 consecutive standing x-rays of girls aged 10 to 14 were examined to see whether enough information was provided for diagnosis and follow-up of the patients using a single 45 x 45 cm detector from a DR device.

Ground plate Th1 was clearly visible in 31% of the cases, ground plate Th2 in 56%, and ground plate Th3 in 88% of the cases. In 100% of those tested, major curvatures (thoracic and lumbar) were fully visible. In 100% of cases, Risser 3 or 4 would have been (or has been) found.

Conclusion: Adolescent girls with scoliosis can be followed and diagnosed using a DR device with a 45 x 45 cm detector for direct radiography with a dramatic reduction in the diagnostic area. The exposure to radiation of children and adolescents with scoliosis can be drastically reduced by reducing the diagnostic area (window) and the exposure period. Expanding the field size to a level higher than Th3 is rarely required for proper diagnosis and follow-up.

Author (s) Details

Hans-Rudolf Weiss
Schroth Best Practice Academy, Neu-Bamberg, Germany.

Sarah Seibel
Department of Radiology, Medizinisches Versorgungszentrum Mittelmosel, Zell-Barl, Germany.

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