Can acute radiation syndrome develop from a large dose delivered only to the hands?

Acute radiation syndrome (ARS) is a serious health condition that arises from exposure to a high dose of ionizing radiation over a short period of time. The critical factor in developing ARS is not just the size of the dose but also the total body exposure. ARS typically occurs when the whole body receives a substantial amount of radiation, usually exceeding 1 gray (Gy), which results in systemic effects affecting multiple organ systems.

When radiation is localized to the hands, even if the dose is large, the majority of the body does not experience the radiation exposure necessary to trigger the widespread biological damage characteristic of ARS. The radiation sickness manifests due to damage to the bone marrow, gastrointestinal tract, and other tissues that have high turnover rates, which requires exposure to a whole-body dose.

Therefore, localized exposure, such as that limited to the hands, does not result in the acute symptoms associated with ARS because the critical systems remain unaffected. This understanding reinforces why the assertion that ARS can develop from radiation only to the hands is inaccurate.