From the 1930s to the 1950’s, shoe stores in big cities around the world used the latest technology to properly fit shoes to your feet: the Shoe Fitting Fluoroscope, which utilized x-ray technology.

The health risks of radiation would not be fully understood until after the machine was used routinely for decades. Radiation, as it turns out, causes more harm in a growing bone, ie. impairs bone growth, as in children’s bones, compared to adult bones. And cancers can take many years, sometimes decades, to form.

First invented in the 1920’s, the shoe fitting fluoroscope, or sometimes called pedoscope, was a modified x-ray machine used specifically for feet, designed in response to all the wounded soldiers who came home from war. Many people received patents in the late 1920’s and soon manufacturers in Wisconsin, Illinois, and the UK began mass producing them.

These x-ray machines allowed visualization of the bones and soft tissues of the foot while inside a shoe, thus allegedly increasing the accuracy of shoe fitting.

The machine grew in popularity in shoe retail stores whose shop owners capitalized on the lure of the new technology.

The 4-and-one-half foot high wooden cabinet had shoe-sized slots built into a step. Below that was a fluoroscope which emitted X-rays, partially enclosed in a shielded box. On top of the cabinet there were three viewers: one for the child or fitter, one for the parent, and one for the saleperson.

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.

A customer, usually a child, would place their feet into the slots, while a salesperson set the amperage and a timer, usually set for 20 seconds (but could be anywhere from 5 to 60 seconds).

“Through the viewer, the child, mother and salesperson could see the bones of the feet, glowing in a yellowish-green color, while a ghostly outline of the show could be seen on the outside.” (source)

The machines were a big hit, and in the early 1950’s, estimates placed the number of operating units in the United States, the United Kingdom and Canada at 10,000, 3,000 and 1,000 respectively.

The typical X-Ray Shoe Fitting Machine delivered a radiation dose of 13 roentgen, though some were much higher, especially if the lead shielding had been removed to make moving the heavy cabinets around easier.

To give you an idea how much radiation that is, 13 roentgen is more radiation than a full-body CT scan, or equal to almost 7 years’ worth of radiation exposure from just being on earth–in one 20 second interval.

The risks of radiation weren’t just for the customers who had their feet X-rayed, but also for any customer in the store, notwithstanding, the employees of the shoe stores, who had to operate the machines day in and day out, sometimes sticking their hands in the machine, and were exposed to all the ambient radiation in the store.

The amount of radiation that leaked from the cabinet exceeded the maximum allowable daily dose of radiation set out in national standards–even at that time.

Interestingly, safety became a featured part of advertising after the potential dangers of radiation were made aware to the public. Advertisement from July 1949:

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. 

In 1957 the State of Pennsylvania became the first jurisdiction to ban the use of shoe fitting fluoroscopes. 

Here is a 1957 case report of a 56 year old woman who has an interesting medical history. She worked in a shoe shop for 10 years and used the shoe fitting fluoroscope 15-20 times daily on customers, often children. In 1950, she had sciatica, and pain in the right leg. In 1952, she had acute anterior poliomyelitis with paralysis of the left leg. Then she had a dislocation fracture, and then her gallbladder removed. Her right foot had dermatitis, ulceration and deformation of the toe nails as a result of radiation exposure. But, everything in her case history could be attributed to radiation exposure.

Another serious injury linked to the operation of these machines involved a shoe model who received such a serious radiation burn that her leg had to be amputated (Bavley 1950).

A 2002 article in German found a 72-year-old female with basal cell carcinoma and history that included regular use of the shoe-fitting fluoroscope. A 2007 case study linked a case of basal cell carcinoma of the foot to the shoe-fitting fluoroscope.

By 1970, 33 states had banned them and strict regulation in the other 17 made them impossible to function.