Background: Extremely restrictive radiology guidelines have recently been adopted within the chiropractic profession that pose a public health threat. Risk assessment from exposure to radiation from diagnostic x-rays are based on the linear no-threshold (LNT) model/hypothesis that has been disproved for use in risk estimates in the low-dose range, i.e. less than 100mGy (10,000mrem).
Discussion: We discuss ten reasons why routine radiography should be the standard in chiropractic practice including: it offers zero harm to the patient; contemporary evidence-based methods require it, these methods lead to better outcomes; incidental findings are important; it increases patient satisfaction; it completes a thorough exam; it satisfies practitioner medico-legal liability concerns; its costs are minimal; alternative methods (i.e. MRI) are not practical for daily practice and are typically performed in the nonphysiologic recumbent position and do not convey appropriate biomechanical information; finally, it may enhance patient health by hormesis.
Conclusion: As opposed to current X-ray reduction efforts and traditional beliefs, the weight of the current evidence substantiates two facts:
1. X-rays are not harmful to patients;
2. X-rays should be a routine part of the comprehensive spinal assessment in order to deliver optimal and contemporary chiropractic care.
Author keywords: Radiation, X-rays, hormesis, spinal radiographs, chiropractic, cancer, clinical practice, risk assessment, biomechanics, vertebral subluxation, spinal adjustment, spinal manipulation
Author affiliations: PAO: Private Practice of Chiropractic, Newmarket, Ontario, Canada; DEH: President, CBP Non-Profit, Eagle, Idaho, United States
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