title: CT Utilization for Pediatric Orthopedic Trauma.
abstract: BACKGROUND
  The use of computed tomography (CT) scanning in trauma has tripled in the past decade in adults and children alike. There is growing concern about the long-term risks of radiation delivery in childhood. There is little information in the literature on radiation exposure during extremity CT in children. This study evaluated the radiation dose and geographic bodily exposure to the child/adolescent during extremity CT.
  
  
  METHODS
  A retrospective review of 163 patients (girls aged 0.5-19 years and boys aged 3.1-19 years) who sustained an orthopedic extremity injury that required a CT scan in 2012 was performed. Data collected included sex, age, height, weight, body mass index (BMI), joint, upper extremity position, body position, scout start, scout end, CTDIvol (mGy), and dose length product (CTDLP (mGy-cm)).
  
  
  RESULTS
  Lower extremity scans were more frequent (124/163, 76 percent) and had higher radiation doses overall. Only the elbow varied for upper extermity positioning. Five of nine were on the side of body with a corresponding 66 percent lower mean radiation dose. All lower extremity scans were in the supine position. Scout CT start and end varied among all joints except for femur to tibia.
  
  
  CONCLUSIONS
  Lower extremity CT scans had the highest radiation doses. Variability in positioning and delineation of scout contributed to variation in radiation exposure of extremity and adjacent body area. Improved localization and consistent positioning can effectively lower radiation exposure in children undergoing extremity CT scan.
authors: Michael
authors: M
authors: Kern
authors: Ashley
authors: A
authors: Tucker
authors: Kenneth
authors: K
authors: Rogers
authors: Richard W
authors: RW
authors: Kruse
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000069076:Fractures, Multiple / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000458:organization & administration; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000706:statistics & numerical data*