Reducing the radiation dosage in patients with a scoliosis.

A significant number of girls develop an adolescent idiopathic scoliosis and require repeated full-length radiographs of the spine. Since Nash's publication in 1979 [16], there has been considerable concern expressed about protecting them from excessive radiation, and particularly from the development of radiation-induced breast tumours. We present a study which compares the differences in radiation dose using different techniques, specifically, the use of a posteroanterior projection, very fast rare earth screens and progressive wedge-shaped filtration. The use of a posteroanterior projection reduced the sternal exposure by 98.9% and the breast skin exposure by 92%. A combination of all three techniques reduced the sternal exposure by 99.5%. We recommend that these should be used routinely to reduce the radiation hazard to children with an adolescent idiopathic scoliosis.