A skeletal survey (also called a bone survey) is a series of

X-ray An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...

s of all the

bone A bone is a Stiffness, rigid Organ (biology), organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red blood cell, red and white blood cells, store minerals, provid ...

s in the body, or at least the axial skeleton and the large cortical bones. A very common use is the diagnosis of

multiple myeloma Multiple myeloma (MM), also known as plasma cell myeloma and simply myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Often, no symptoms are noticed initially. As it progresses, bone pain, an ...

, where tumour deposits appear as "punched-out" lesions. The standard set of X-rays for a skeletal survey includes X-rays of the

skull The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, the ...

, entire

spine Spine or spinal may refer to: Science Biology * Vertebral column, also known as the backbone * Dendritic spine, a small membranous protrusion from a neuron's dendrite * Thorns, spines, and prickles, needle-like structures in plants * Spine (zoolog ...

pelvis The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The ...

rib In vertebrate anatomy, ribs ( la, costae) are the long curved bones which form the rib cage, part of the axial skeleton. In most tetrapods, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the ches ...

s, both

humeri The humerus (; ) is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a round ...

and

femora The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with t ...

(proximal long bones). It is more effective than isotope scans at detecting bone involvement in

. Although significantly less sensitive than

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...

, it is easier to include more bones. A study found that MRI of just the spine and pelvis would have detected 9% fewer cases of bone involvement than the more extensive skeletal survey which therefore remains the standard method. Skeletal surveys are also used with suspected non-accidental injury in children (CE guidelines state that 19 images of the child are taken.) These are reported on by a consultant paediatric radiologist and often copies are made. Non-accidental injury is suspected if a child sustains an injury where the clinical findings are not consistent with the explanation given for the injury, such as a

spiral fracture A spiral fracture (a.k.a. torsion fracture) is a bone fracture occurring when torque (a rotating force) is applied along the axis of a bone. Spiral fractures often occur when the body is in motion while one extremity is planted. For example, a spi ...

in a child who is not yet walking. A skull CT is also done in connection with the radiographs if the child is under one year old or, if the child is older, where there is a clinical requirement (perioribtal ecchymosis, for example) as to rule out

abusive head trauma Shaken baby syndrome (SBS), also known as abusive head trauma (AHT), is the leading cause of fatal head injuries in children younger than two years. Diagnosing the syndrome has proved both challenging and contentious for medical professionals, ...

. The results of a skeletal survey may be used in a court of law as evidence of child abuse.

References

Projectional radiography {{med-diagnostic-stub