• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Home
  • Online Consultation
  • About
  • Newsletter/Updates
  • Contact Us
  • Policies

Bone and Spine

Orthopedic health, conditions and treatment

  • General Ortho
  • Procedures
  • Spine
  • Upper Limb
  • Lower Limb
  • Pain
  • Trauma
  • Tumors

Skeletal Survey or Bone Survey – Indications and Uses

By Dr Arun Pal Singh

In this article
    • Indications of skeletal survey
    • Skeletal Survey in Child Abuse or Nonaccidental injury
    • Skeletal survey for other Causes Such as Syndromes
    • Skeletal Survey for Endocrine Lesions
    • Skeletal Survey of Neonates
      • X-rays in case of syndromes
      • X-rays in case of Infections
    • Use of Skeletal Survey
      • Related

A skeletal survey is a series of x-rays which are done to view the entire skeleton, performed systematically to cover the entire skeleton or the anatomic regions as per clinical indications.

Different clinical indications may demand a different set of x-rays. In the case of child abuse, which is a common indication, the local health protocols may differ slightly on the inclusion of different views of x-rays.

A bone survey takes X-rays of the:

  • skull
  • ribs
  • spine
  • pelvis
  • long bones [forearm, humerus, leg, femur]
  • any other bones that need to be looked at

A joint survey is often done along and includes views of wrist, elbow, shoulder, ankle, knee, hip and sacroiliac joints.

The aim of the skeletal survey is to identify focal or diffused abnormalities of the skeleton and in case of children to differentiate them from anatomic variations or developmental changes.

Indications of skeletal survey

  • Child abuse [suspected or known]
  • Widespread infections
  • Skeletal dysplasias
  • Bony Lesions
    • Multiple myeloma
    • Eosinophilic granuloma
    • Metastasis
  • Paget’s disease
  • Metabolic bone disease like hyperparathyroidism
  • Rickets
  • Scurvy
  • Polyarticular arthropathy

It must be mentioned that barring child abuse, the survey is not required only when there are diagnostic difficulties.

Skeletal Survey in Child Abuse or Nonaccidental injury

  • Skull  – AP and Lateral views
  • Chest
    •  AP & Lateral in inspiration
    • Right and Left oblique for Ribs
      • Done in inspiration –
      • Include lower ribs.\
  • Abdomen
  • Pelvis
  • Bilateral femora
  • Both legs AP
  • Both feet AP
  • Coned view bilateral knees   AP
  • Coned view bilateral ankles  AP
  • Bilateral arms with hands –  AP
  • Lateral view of spine

A follow-up survey is done after two 2 weeks.

The follow-up survey is usually the same as above except for skull, spine, and pelvis usually.

But if these were regions of concern previously, they should be included.

Skeletal survey for other Causes Such as Syndromes

Following is the list that generally encompasses most of the regions. But the x-rays to be done can be modified depending on the type of lesion and region of interest.

[While body CT is a more sensitive, faster and convenient investigation as compared to the skeletal survey. Availability, cost, and concerns for radiation dose are the drawbacks though]

  • Skull AP and Lateral views
  • Chest PA and Lateral views
  • Abdomen including pelvis
  • Left leg AP view
  • Left-arm AP view
  • Lateral view of the spine including the sacrum
  • Bilateral wrists and hands AP view
  • AP or dorsoplantar view of the foot

Skeletal Survey for Endocrine Lesions

  • Skull 3 views
    • Anteroposterior
    • Townes view
    • Lateral view
  • Chest X-ray
    • Posteroanterior view
    • Lateral view
  • Abdomen including the pelvis and upper femora
  • Both legs AP view
  • Both feet dorsoplantar view
  • Both arms anteroposterior view
  • Lateral view of the spine

Skeletal Survey of Neonates

These are usually done in cases of syndromes and infection

X-rays in case of syndromes

  • AP and lateral views of the skull
  • Ap and lateral views of chest including thoracic spine
  • Lateral views of the lumbar, sacral & cervical spine
  • Abdomen including pelvis
  • Left leg, foot, arm and hand
    • In case of asymmetries include both upper limbs

X-rays in case of Infections

  • Babygram
    • Anteroposterior and lateral images of the child
    • Should include chest, abdomen, shoulders & hips
  • Both arms AP views
  • Both legs AP
  • Views of the involved region if there is a local swelling or erythema.
Babygram or skeletal survey in congenital rubella syndrome
Babygram or skeletal survey in congenital rubella syndrome
Image Credit: Open-i

Use of Skeletal Survey

X-rays are basic investigations and have widespread availability.

Skeletal survey, by the sheer number of x-rays included, requires preparations at all the fronts.

In the case of child abuse, the skeletal survey is mandatory in all cases of children younger than 2 years.

However, this screening is not found of much value in children older than 5 years.

The children between 2- to 5-year-olds must be considered individually.

For other ailments and lesions, whole body CT is a faster and convenient choice. But still, the skeletal survey is used as it is easily available.

 

Related

Spread the Knowledge
1
Share
 
1
Share
1    

Filed Under: Procedures

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Primary Sidebar

Browse Articles

snapping hip syndrome

Snapping Hip Syndrome

In snapping hip syndrome there is an audible snap or click that occurs in or around the hip. Snapping hip syndrome may be called External – Snapping of the iliotibial band or gluteus maximus over the greater trochanter Internal – Snapping of the iliopsoas tendon The condition occurs most often in individuals aged 15-40 years […]

Deformity After Fracture Clavicle

Clavicle Fracture Diagnosis, Treatment and Complication

Clavicle fracture is often caused by a fall onto an outstretched hand, fall onto the shoulder, a direct blow to the shoulder. Eighty-seven percent get fracture clavicle due to fall onto the shoulder. Direct trauma to clavicle can occur with either blunt or penetrating trauma. Sporting activities that may result in direct trauma to the […]

Radiation therapy to the pelvis

Radiation Therapy for Tumors

Radiation therapy is a form of cancer treatment which uses high-energy radiation such as X-rays, gamma rays, and charged particles to shrink tumors and kill cancer cells. The radiation may be delivered by an external machine external-beam radiation therapy or by material placed in the body near cancer cells (internal radiation therapy, also called brachytherapy). […]

Popliteus Tendinopathy occurs in Popliteus Muscle

Popliteus Tendonitis Symptoms and Treatment

Popliteus tendonitis is an uncommon pathology that which often occurs in athletes and people with a history of other knee ligament injuries. The pathology involves popliteus muscle which is present on the posterolateral aspect of the knee region. Popliteus muscle is a key stabilizer of the knee, and plays an important role in maintaining proper […]

Simulation photograph of tennis elbow to depict point of pain

Tennis Elbow or Lateral Epicondylitis

Tennis elbow or lateral epicondylitis is a term for a painful condition of elbow because of tendinosis of extensors of the wrist at the attachment on the lateral epicondyle. Lateral epicondyle is part of the distal humerus on the lateral or outer side of the elbow. Extensor carpi radialis brevis tendon is most commonly involved […]

A fixed scaphoid fracture

Internal Fixation of Scaphoid Fracture

Internal fixation of scaphoid can be done either percutaneously or using open reduction. In modern orthopedic practice, percutaneous fixation of the scaphoid is preferred where feasible because it is minimally invasive and there is no need for wide dissection and tissue injury caused by surgical dissection. Preoperative Planning The fracture pattern should be clear. Conventional […]

Cold Abscess Causes, Presentation and Treatment

The term cold abscess refers to an abscess [An Abscess is a collection of liquefied tissue(pus) in the body] where typical signs of abscess [warmth, redness, tenderness,] are absent. The prefix cold indicates that the abscess is not hot because that is the usual case. Thus a cold abscess is not accompanied by the classical […]

© Copyright: BoneAndSpine.com
Manage Cookie Consent
The site uses cookies. Please accept cookies for a better visiting experience.
Functional Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes. The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
Manage options Manage services Manage vendors Read more about these purposes
View preferences
{title} {title} {title}
 

Loading Comments...