Shoe-Fitting Fluoroscope (ca. 1930-1940)

The shoe fitting fluoroscope was a common fixture in shoe stores during the 1930s, 1940s and 1950s. A typical unit, like the Adrian machine shown here, consisted of a vertical wooden cabinet with an opening near the bottom into which the feet were placed. When you looked through one of the three viewing ports on the top of the cabinet (e.g., one for the child being fitted, one for the child's parent, and the third for the shoe salesman or saleswoman), you would see a fluorescent image of the bones of the feet and the outline of the shoes.





According to Williams (1949), the machines generally employed a 50 kv x-ray tube operating at 3 to 8 milliamps. When you put your feet in a shoe fitting fluoroscope, you were effectively standing on top of the x-ray tube. The only “shielding” between your feet and the tube was a one mm thick aluminum filter. Some units allowed the operator to select one of three different intensities: the highest intensity for men, the middle one for women and the lowest for children.  


Most units also had a push button timer that could be set to a desired exposure time, e.g., 5 to 45 seconds.  The most common setting was 20 seconds. 





In 1946, the American Standards Association established a “safe standard or tolerance dose,” that the feet receive no more than 2 R per 5 second exposure. Children were not to receive more than 12 such exposures in a single year. The State of New York adopted similar requirements in 1948, and other states and major cities began to follow suit.  As a result, the manufacturers of shoe fitting fluoroscopes became concerned that their products would have to meet a myriad of standards that varied from location to location, and they asked the American Conference of Governmental Industrial Hygienists (ACGIH) to recommend a uniform set of standards. The ACGIH did so and issued their guidance in 1950, an event that allowed the manufacturers to advertise that they met the ACGIH standards.
By the early 1950s, a number of professional organizations had issued warnings about the continued use of shoe-fitting fluoroscopes, e.g., the ACGIH,  American College of Surgeons, New York Academy of Medicine and the American College of Radiology. At the same time, the District of Columbia issued regulations that shoe fitting fluoroscopes could only be operated by a licensed physiotherapist. A few years later, Massachusetts passed regulations requiring that the machines be operated by a licensed physician.  In 1957 the State of Pennsylvania became the first jurisdiction to ban the use of shoe fitting fluoroscopes. By 1960, these events, plus pressure from insurance companies, had led to the demise of the shoe-fitting fluoroscope, at least in the U.S. In the end, the shoe stores were probably just as glad to be rid of the things  - at least one survey had indicated that the machines were perceived by shoe salesmen a sales gimmick rather than a useful tool.
Attempts to impose regulatory restrictions on the use of shoe fitting fluoroscopes seem to have been limited to the United States . Despite considerable effort, Jacalyn Duffin and Charles Hayter, authors of the aforementioned “Baring the Sole: The Rise and Fall of the Shoe Fitting Fluoroscope,” could not find any Canadian or British legislative action pertaining to these devices. In fact, Duffin and Hayter noted that these machines continued to be used in Canada and the UK , albeit to a limited extent, at least until 1970. 

Read more at orau.org/ptp/collection/shoefittingfluor/shoe.htm

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