ירחון החברה הישראלית לפדיאטריה אמבולטורית (חיפ"א) גיליון 2018-2

25 Coon, et al, also addressed the latter issue stating that, " Decreasing Use of CT for appendicitis associated with equivalent or better outcomes." The initial evaluation of these conditions is usually performed by the community Pediatrician or Family doctor. Our evaluations and referrals have a significant impact on patient outcome. A referral to ED for febrile seizure increases the likelihood of diagnostic imaging. The same for abdominal pain and of course, suspected appendicitis. In the latter, imaging is often desirable, but it is up to the hospital ER physician, surgeon and the radiologist to know the benefits of Ultrasound. However, the ball starts to roll out of the Pediatrician's office and that often dictates where the patient will end up. Our judicious recommendations can direct the following patient care. The risks of radiation exposure are known, but are difficult to quantify. Studies however, do exist that can estimate risk. Back in 2013, Miglioretti, et al, in JAMA Pediatrics, published a risk stratification of CT scans. Let's try to estimate some of the risks that they quantified: 1. For females aged 5-9 years of age, an abdominal CT is associated with a risk of cancer at: a. 1/200 b. 1/400 c. 1/1000 d. 1/5000 2. For every head CT, solid organ cancer risk is close to: a: 1/500 b: 1/1000 c: 1/5000 d: 1/10000 Most notorious was the estimated risk of 1/400 for solid organ cancer for every abdominal/pelvic scans for females 5-9 years of age. Similar risk was projected for chest-spine CT scans as well.