RadteraXR Skeletal Survey / Bone Survey
XRNo contrastMSKverify
Indications
- Suspected non-accidental injury/child abuse (children <2-5 years)
- Multiple myeloma / plasma cell disorder staging
- Metastatic disease survey
- Metabolic bone disease
- Skeletal dysplasia/syndrome evaluation
- Langerhans cell histiocytosis
Patient prep
- Remove radiopaque objects; gown
- For pediatric NAI, dedicated separate exposure of each region (no 'babygram')
Contrast
None / non-contrast
Technique
- A standardized series of dedicated radiographs of the entire skeleton, each anatomic region imaged separately with optimized technique
- Pediatric NAI per ACR-SPR: AP/lateral skull, lateral C-spine, lateral T- and L-spine, AP chest (with bilateral oblique ribs), AP pelvis, AP each humerus, AP each forearm, PA hands, AP each femur, AP each lower leg, AP feet
- Adult myeloma/metastatic survey: skull (AP/lateral), C/T/L spine (AP/lateral), chest, pelvis, both humeri, both femora (and symptomatic areas) — note: whole-body MRI/low-dose CT/PET increasingly preferred
- SID per region; grid for axial/thick parts; collimate each region
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Skull AP and lateral | Frontal/Sagittal | Both projections for vault fractures/lesions |
| 2 | Spine (C/T/L) | Frontal/Sagittal | Lateral C-spine, AP and lateral thoracic and lumbar spine |
| 3 | Chest AP with oblique ribs | Frontal/Oblique | Pediatric NAI adds bilateral oblique ribs for posterior rib fractures |
| 4 | Pelvis AP | Frontal | Includes hips |
| 5 | Upper extremities (AP humeri, forearms, PA hands) | Frontal | Each limb imaged separately |
| 6 | Lower extremities (AP femora, lower legs, AP feet) | Frontal | Each limb imaged separately |
Key points
- For suspected child abuse, each region MUST be a separate dedicated exposure — single whole-body 'babygram' is unacceptable
- Follow-up skeletal survey ~2 weeks later increases sensitivity for healing fractures in NAI
- Adult myeloma surveys are increasingly replaced by whole-body low-dose CT, MRI, or PET per current guidelines
- Add coned-down/oblique views of suspicious areas (e.g., metaphyseal corner fractures)
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.