Skeletal Survey

What is a skeletal survey?

A skeletal survey is a series of X-rays to identify any problems with your child’s bones. A skeletal survey is normally done in situations where it is not clear how a fracture has happened or where there are concerns about a possible fracture; to gather more information.

Why is it necessary?

Babies and young children often cannot tell us reliably if they are experiencing pain. Also, we are not always able to see signs of a fracture on physical examination. Skeletal survey therefore remains the best way to identify bone problems in children.

Radiation

The overall radiation exposure from this series of X-rays is low when compared with lifetime exposure to environmental radiation. During a skeletal survey, efforts are made to minimise radiation while at the same time getting good quality X-rays.

Consent for skeletal survey

Your child’s doctor will fully explain why it is necessary and what exactly is involved before requesting consent.

What will happen on the day?

The doctors will decide if your child will be given sedation for the skeletal survey. If so, you will be given instructions on whether your child needs to have a period without eating or drinking beforehand. The sedation will be given on the ward or in the X-ray department. Your child will be taken to the X-ray department. If you are able to, you may escort your child with the nurse. The radiographers will greet you at the X-ray room and begin the skeletal survey.

What will happen in the X-ray department?

The radiographer (X-ray specialist) who will be taking the X-ray pictures will reaffirm consent and check your child’s identity. Approximately 36 X-ray images will be taken, this will take at least an hour. We ask you to stay calm and if your reactions are causing distress to the staff and/or your child, you may be asked to leave the X-ray room if this is in the best interests of all involved.

Once the X-rays have been taken they need to be reviewed by a specialist X-ray doctor to make sure no more images are required. We appreciate your patience during this time.

What can we offer to make the process easier for your child?

We understand this may be distressing; you can bring something of comfort for your child such as a soft toy. Where possible a play specialist will be present during the procedure to help keep your child comfortable. Where appropriate your child will also be given sedation medication by mouth.

Why is a second survey needed?

Some bone injuries are not visible immediately when the first X-rays are taken; only appearing weeks later. We therefore request your child to return in approximately two weeks for a follow-up skeletal survey. You will be given an appointment for this before you leave the ward. The follow-up involves less X-rays and so is usually shorter.

Anything else we feel important for you to know?

In order to have appropriately trained staff present, skeletal survey examinations at UCLH are carried out during working hours; Monday to Friday 9-5. This means that if your child is admitted on a Friday evening they will have to remain in hospital until at least Monday.

If you need more information?

Your child’s doctor and nurse will be happy to answer any further questions you have while on the ward.