Say your child falls off the jungle gym at the playground. She didn't lose consciousness, but her leg is bent where it shouldn't be. You think she might have a broken bone, but you need a doctor to confirm. Should you take her to the nearest emergency room, or should you drive farther to get her care from a pediatric specialist?

When it comes to radiology — a medical specialty that uses imaging technologies such as X-rays, CT scans (computed tomography) and MRIs (magnetic resonance imaging) to diagnose injuries and illnesses — pediatric expertise matters. Not only will it help your child get the best possible care, but it can also save you time and money.

Why adult-focused radiology isn’t always right for kids

When you take your injured child to a non-pediatric specialized emergency department, the doctor may perform a full-body CT scan. This type of scan combines hundreds of X-rays to create 360-degree images that give radiology specialists a detailed look into the body. The problem is that this type of scan might not provide the information that the doctor needs to effectively treat your child.

"We see kids all the time who got a full CT and didn't need it," says Jason Kotas, manager of EMS Outreach and Education at Children's Colorado. "And a lot of times, we can't even use the scan."

Additionally, a radiologist without pediatric training might choose to use contrast for the CT scan, in which a fluid is injected into the body to make the blood light up. This can show the radiologist if there is internal bleeding. However, because of the way blood flows in the brain, the fluid can also obscure the nuanced information needed to assess brain injury, making the scan unusable.

Kari Hayes, MD, a pediatric radiologist at Children's Hospital Colorado, estimates that about 40% of the images she receives from non-pediatric specialists could have been ordered a better way based on the patient’s age. This can mean that tests show up on your hospital bill that weren’t needed.

"In this case, a head CT would be warranted, since this child fell more than three meters," says Dr. Hayes. "But she doesn't need that spine CT or abdomen CT. She just needs a head CT and a leg X-ray.”

Is radiation exposure a concern for kids?

An unnecessary CT scan doesn’t just add an expense for the family — it also exposes children to additional radiation that damages DNA and can cause cells to mutate into serious diseases, such as cancer. While this risk is very low, it's best that kids are exposed to the least amount of radiation possible when they need a CT scan.

"There's no specific amount of radiation that causes cancer,” Dr. Hayes says. “We estimate we're increasing a kid's lifetime chance of cancer by about a tenth of a percent with a full-body scan. But if we don't need to expose you to that risk, why do it?"

Why choose an expert in pediatric radiology

When a CT scan or X-ray is required, a pediatric radiologist will know exactly which tests are needed, and how to minimize radiation exposure. "Kids have different issues than adults," Dr. Hayes says. "Pediatric doctors and nurses are trained to recognize them."

A pediatric trauma doctor, for example, would likely know the diagnostic protocol for a kid who has fallen off the playground, at that child's age, with that child's symptoms. They'd be equipped to order targeted tests, rather than casting a wide but imprecise net, like the full-body scan.

A pediatric radiologist would know how to calibrate the machine to the patient's size, performing a focused pediatric CT scan and thereby minimizing radiation. And a pediatric orthopedist would know how to repair a broken bone to minimize disruption to the growth plate — reducing the chance of problems down the road.

Pediatric radiologists are also trained to help keep kids calm during a stressful, and sometimes painful, hospital visit.

"It's as simple as just getting them to sit still for an X-ray so you can read it," Dr Hayes says. "We're trained to be that comforting voice in the chaos. That's more than giving them a sticker. It's the art of distraction. It's communicating in a way that's developmentally appropriate, explaining procedures in a way they can understand."

Patient-friendly radiology reports

Radiology reports can be filled with complicated words that are hard for caregivers and families to understand. That’s why, at Children’s Colorado, families can use a tool called Scanslated to view patient-friendly radiology reports right in their child’s MyChart account.

Scanslated is an interactive tool designed to help parents and caregivers better understand what was scanned and what the results are. You can click on certain words in the report to learn a user-friendly definition. Families can also view diagrams to see what body parts the report is referring to, and what the doctors did or didn’t find. Scanslated offers reports in both Spanish and English.

Pediatric radiology leads to better diagnoses and treatment

"If you're having a heart attack, you don't want a foot surgeon," says Kotas. "It's no different for kids."

Just like feet aren't hearts, kids are not adults. Where adult diseases tend to be the result of many years of exposure, kids' diseases tend to be ingrained in their genes. Kids' bones are softer and more pliant, meaning trauma affects them differently. They have different vitals. Their breathing is faster and shallower. Their hearts beat faster.

For pediatric specialists, all those differences make up what it means to care for kids — they are the backbone of their pediatric training, which typically requires an extra year of education.

"It's not just fluff. It's better outcomes, shorter length of stay, less medicine needed, less perceived pain,” Kotas says. "It's calming the kid down so they're not screaming and flailing, so you can get the IV in on the first try and not have to poke them a bunch of times. There's a lot of background knowledge that allows those interactions to go smoothly."

In other words, if your child needs an X-ray, CT scan, MRI or other form of radiology imaging, seeking out pediatric expertise at a children's hospital can make a difference — for both your child’s health and safety and your wallet.