An audit of skeletal surveys for suspected non-accidental injury following publication of the British Society of Paediatric Radiology guidelines.
OBJECTIVE
To audit change in the content and standard of skeletal surveys in the UK following the publication of the British Society of Paediatric Radiology (BSPR) guidelines for skeletal surveys in suspected non-accidental injury.


METHODS
One hundred skeletal surveys, which were performed throughout England and Wales between February 2004 and September 2006 and received for a second opinion at a single children's hospital, were reviewed. The views obtained were compared with the defined reference standard 20 views as recommended by the BSPR. Additionally, each view was assessed for technical quality out of a maximum score of 11. The results were compared with an earlier study published prior to the definitive guideline. Additional information included whether images were film or digital and whether a computed tomography examination of the head was documented.


RESULTS
A mean of 16.5 (range 5-20) of the 20 recommended views were covered per survey and 15% of surveys included all 20 recommended views (previously 0%). The mean technical score per film was 9.7/11 (88%). Sixty-two percent of the skeletal surveys were digitally acquired and 59% included a CT examination of the head.


CONCLUSIONS
There is still considerable variation in skeletal surveys performed in the UK, but progress has been observed in all areas in the light of the BSPR guidelines. There remains room for improvement, and further publicity of the guidelines is recommended.
Swinson
S
S
Birmingham Children's Hospital, Birmingham, UK. sophieswinson@doctors.org.uk
Tapp
M
M
Brindley
R
R
Chapman
S
S
Offiah
A
A
Johnson
K
K
D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012886:Skull / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D006113:United Kingdom