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Diagnostic Tests: Skeletal Survey
Overview — What This Test Is
A skeletal survey is a comprehensive radiographic examination of the entire skeleton. It consists of multiple plain X-rays taken of all major bones and is designed to identify fractures, lytic or blastic lesions, and other bony abnormalities that may not be apparent on a single, focused imaging study.
When to Answer Skeletal Survey
You should choose a skeletal survey when there is clinical suspicion of systemic or multifocal bone pathology, particularly in the following scenarios:
Overview — What This Test Is
A skeletal survey is a comprehensive radiographic examination of the entire skeleton. It consists of multiple plain X-rays taken of all major bones and is designed to identify fractures, lytic or blastic lesions, and other bony abnormalities that may not be apparent on a single, focused imaging study.
When to Answer Skeletal Survey
You should choose a skeletal survey when there is clinical suspicion of systemic or multifocal bone pathology, particularly in the following scenarios:
- Suspected child abuse
This is a classic and high-yield indication. The skeletal survey is used to detect:- Multiple fractures at different stages of healing
- Injuries inconsistent with the reported mechanism
- Rib, clavicle, metaphyseal, or long-bone fractures
Example:
An 8-year-old child with a history of a minor fall (e.g., from a chair) but with multiple bruises or fractures → suspect non-accidental trauma and order a skeletal survey.- Multiple myeloma
Used to identify lytic bone lesions, especially when evaluating unexplained anemia, bone pain, or abnormal SPEP findings. - Metastatic bone disease
Helps detect widespread bone metastases, particularly from cancers such as breast, prostate, lung, or kidney.
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