Optimizing Clinical Use of Radiography and Minimizing Radiation Exposure in Chiropractic Practice
MOOTZ, RD; HOFFMAN, LE; HANSEN, DT;
TOPICS IN CLINICAL CHIROPRACTIC. 1997 MAR Vol. 4(1) Pgs. 34-44

ABSTRACT: Purpose: Approaches to minimizing radiation exposure are discussed. Issues in clinical decision making, technical considerations, and imaging criteria are reviewed. Examples of radiographic guidelines are provided, and a case study of a chiropractic managed care organization's implementation of a diagnostic imaging guideline is presented. The roles and impact of educational institutions, trade associations, regulatory agencies, and private sector organizations are examined.

Method: A qualitative literature review of approaches to minimize radiation and of the validity and reliability of chiropractic radiographic analysis procedures was undertaken. Examples of selected imaging guidelines illustrate efforts to provide systematized information to practitioners. Observational data regarding chiropractic utilization of radiographs before and after implementation of radiographic criteria are presented. Summary: The clinical decision to take radiographs has the largest potential impact on the radiation exposure of patients.

Regulatory and economic incentives also play a substantial role. Imaging guidelines based on clinical criteria are increasingly used to ensure quality and appropriateness in imaging and to minimize patient exposure. These guidelines may be useful for the clinician in providing comprehensive, low-cost, and low-risk health care.