Answer to Question #12274 Submitted to "Ask the Experts"

Category: Medical and Dental Patient Issues — Diagnostic X Ray and CT

The following question was answered by an expert in the appropriate field:

Q

About a month ago I went to a chiropractor, and he took a total of five plain-film x rays of me. Two were of my back (one side view and one facing forward). Three were of my neck—one was of my entire head and neck to just below my shoulders, and the other two smaller pictures were of my neck from side views. I was wondering if I have been exposed to too much radiation from these x rays because there were so many of them. I called the chiropractor's office and asked the lady if that was a lot of radiation, and she said I would get more exposure from dental x rays. I find that hard to believe because dental x rays are digital, and a person is covered with a lead apron. Can you tell me how much radiation I was exposed to?

A

Often several images are taken when looking for spine issues, so it is not unusual to have five films taken. For example, a typical lumbar spine (lower back) series consists of five images. The typical effective dose from a lumbar spine series is 1.8 millisieverts (mSv). Images of the head, neck, and upper back result in lower doses. I cannot estimate your dose based on the information you provided, but based on your description of image locations, it should be less than 1.8 mSv.

You are right that the lady at the chiropractor's office is wrong. Regardless of whether dental facilities use lead aprons or whether they use digital receptors or film receptors, dental x rays result in very low doses because in large part, a very limited amount of the body is exposed to the direct beam.

The risks of health effects from radiation doses received during diagnostic imaging procedures are either too small to be observed or are nonexistent. The benefits from properly performed, clinically indicated, diagnostic imaging procedures far outweigh any hypothetical cancer risk. Diagnostic medical imaging procedures provide a medical benefit to you even if they do not appear to reveal anything, and they are of less risk than their alternatives, such as exploratory surgery. In the case of chiropractic medicine, it's important to know where to perform spinal manipulations. I'm speculating here, but I would think it important to know if there are any underlying spinal issues which may be exacerbated by the pressure applied during a spinal adjustment.

Even if the result of the imaging exam was negative, the physicians were provided information they could use to determine the next course of action. Refusing medical imaging procedures may result in real and substantial risk when a patient does not receive the clinical benefits of the procedures.

Kent Lambert, CHP, FHPS

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