Paediatric radiography - the avoidance of late radiation damage to the growing hip

Epiphyseal plates of growing bones are sensitive to ionizing radiation and this poses problems for the paediatric radiotherapist. In this case report we describe a child in whom electron beam therapy to the groin delivered only low dose radiation to the proximal hip epiphyses - 130 cGy fractionated over 5 weeks - but who suffered late maldevelopment. We explore the success of various radiotherapy techniques in minimizing the dose to the hip epiphyses in four other children. The appropriate positioning of the limb, the choice of treatment modality and, where possible, individual shielding blocks are considered and their effect on the dose to the hip estimated. Absorbed doses of radiation delivered to the midpoint of the proximal femoral epiphyses have been retrospectively determined. (author)