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Skeletal Survey

Definition

A full radiographic series of the skeleton (AP skull, lateral skull, chest, spine, pelvis, and all long bones) performed in suspected NAI to detect occult fractures. Repeat imaging at two weeks improves sensitivity for healing fractures.

Views included
AP and lateral skull, chest, spine, pelvis, long bones
Main indication
Suspected non-accidental injury in young children
Repeat interval
About two weeks after the initial series
Reason for repeat
Improves detection of healing fractures

Common questions

Why repeat the imaging after two weeks?+

A fresh, non-displaced fracture can be radiographically invisible at first. By two weeks the callus that forms during healing shows up on film, revealing fractures the initial series missed.

Is a skeletal survey the only imaging used in suspected abuse?+

No, it is often paired with other modalities such as a bone scan or targeted CT when a survey finding needs clarification, but it remains the standard first-line screening series.

Related terms

Abusive Head Trauma (AHT)
Intracranial injury resulting from violent shaking, with or without impact. Findings include subdural haematoma, subarachnoid haemorrhage, diffuse axonal injury, and retinal haemorrhages....
Child Advocacy Centre (CAC)
A child-focused facility that houses the medical, investigative, and support functions of a child abuse case in one location. The multidisciplinary team...
Metaphyseal Corner Fracture
A fracture through the metaphyseal collar of a long bone, producing a triangular or bucket-handle fragment. Caused by traction and torsion forces...
Non-Accidental Injury (NAI)
Physical harm inflicted deliberately or through gross neglect rather than by accident. The term is preferred over 'child abuse' in clinical documentation...
Posterior Rib Fracture
A fracture at the posterior rib near the costotransverse junction. Produced by forceful anteroposterior chest compression (as in squeezing), not by simple...

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