Observational study of skeletal surveys in suspected non-accidental injury.

AIM To document variability in the standard of skeletal surveys received for a second opinion in suspected non-accidental injury (NAI). MATERIALS AND METHODS The skeletal surveys of 50 consecutive infants and children under 2 years of age were reviewed. A simple scoring system was developed based on fulfillment of specific parameters. Each radiograph was then assigned a score reflecting its overall clinical quality. RESULTS There was an average of 10 radiographs per skeletal survey (range 2-13). Of the 50 surveys assessed, there were 37 different combinations. These included five babygrams. No survey complied with the current draft guidelines of the British Society of Paediatric Radiologists (BSPR). CONCLUSIONS There is significant variability in skeletal surveys referred for a second opinion in suspected NAI. Standardization of projections and improvement in the quality of radiographs obtained for this indication is required. The study highlights the need for the development and dissemination of definitive national guidelines.