FDA urges caution on X-rays for children

January 9, 2018 GMT

Chances are, by the time they’ve reached adulthood, most people have had at least one X-ray taken in their lives. Perhaps it was after a bad fall to see if there were broken bones, or during a routine trip to the dentist’s office. But the U.S. Food and Drug Administration is advising that, due to the radiation involved in these exams, caution should be taken when using them on children.

According to the FDA, the risks from the radiation associated with X-rays is small, especially when compared with the benefits of an accurate diagnosis. However, pediatric patients generally require less radiation than adults to obtain a quality image from an X-ray exam.

Although the level of ionizing radiation from X-ray imaging is generally very low, but can contribute to an increased chance of cancer.

In its new guidelines, the FDA recommends that medical X-ray imaging exams be optimized to use the lowest radiation dose needed for pediatric patients. These exams, which include computed tomography, fluoroscopy, dental, and conventional X-rays, should be performed on children and younger patients only when the health care provider believes they are necessary to answer a clinical question or to guide treatment.


The FDA defines the pediatric population as birth through 21 years old. However, the optimization of image quality and radiation dose in X-ray imaging depends more on a patient’s size than their age. Smaller patients require less radiation to obtain a medically useful image. Technically, the patient’s body thickness (the distance an X-ray travels through the body to create the image) is the most important consideration when “child-sizing” an image protocol.

The FDA encourages parents and caregivers to talk to their child’s health care provider about X-rays and suggests keeping track of their child’s medical-imaging histories. The agency also suggest asking the referring physician about the benefits and risks of imaging procedures, such as: How will the exam improve my child’s health care? Are there alternative exams to X-rays that are equally useful?

It’s also recommended that parents ask the imaging facility how it uses reduced radiation techniques for children and whether there is any advanced preparation necessary.

The FDA encourages health care professionals and hospital administrators to refer to guidelines and instructions provided at the agency’s Pediatric X-ray Imaging web portal.

For more information, visit the FDA’s Pediatric X-ray Imaging website.