Skeletal Survey for Children

Health care professionals have a duty to protect children (safeguarding). This can be very difficult for the parents and carers but our duty to protect the child is paramount and the skeletal survey is only performed when absolutely necessary. The consultant paediatrician in charge of the care of your child should explain the reasons for the examinations prior to you attending the Radiology (X-ray) Department for your appointment.

In order to carry out the skeletal survey, a young child will always need a series of skeletal X-rays and often a CT (computerised tomography) scan of the brain. On rare occasions other tests may also be requested, including ultrasound, and MRI (magnetic resonance imaging).

This is a comprehensive series of X-ray images that shows all the bones in the body. This will be carried out in two separate visits to the Beta Suite of the Imaging Department on the ground floor of the main building at Colchester Hospital.

This is done with your child as an inpatient on the children’s ward.
You will be accompanied to the X-ray department by a registered paediatric nurse from the ward, and this should be someone that you and your child are familiar with. A hospital play specialist may also be present during the examination depending on your child’s needs.
Approximately 20-30 images will be taken on this occasion. And the procedure may take up to an hour to complete.

The examination may be timed to coincide with the CT scan (if your child is having one), or depending on the age of the child, scheduled after a feed to enable him or her to be as still as possible for the images.

You will be asked to sign a form giving consent for your child to be held in the correct position for the X-rays. If your child has a favourite toy or comforter, please bring it along with you.
The examination is carried out by experienced radiographers who are skilled in dealing with children. They will help you and your child get through the process with the least upset and inconvenience.

If your child becomes distressed during the examination we are able to stop for a short break to calm your child.

Once the procedure is over you will be asked to remain in the department for a short while. This is to allow the images to be looked at by a consultant pediatric radiologist to ensure all the radiographic information has been obtained. Once this has been done, sometimes further X-rays may be required before you leave or you will be able to return to the ward.

During this time you will be asked to make an appointment to return for further X-rays approximately 10 days later.
A preliminary report will not be ready until the radiologist has carefully checked all the images. This may not be on the same day but will usually be shared with you as soon as it is available.

Before you leave the department you will have an appointment to return to the Beta Suite to complete the survey with a further series of approximately 10 images.

This is a very quick examination to look at the brain.
The scanner looks like a doughnut. Your child will need to lie down on the table so they can be positioned correctly. The scan is a relatively quick examination. However, sometimes a medicine (sedative) is given to your child to help them keep still.

The scan images will be seen by the consultant radiologist, and a report sent to the requesting paediatrician/ doctor. This report will usually be shared with you once it is available.

Parents/Carers may be able to stay in the room during the examinations. The radiographer will tell you where you can stand or sit to ensure you are safe at all times. You will be asked to wear a heavy, lead, rubber apron to protect you from scattered radiation during examinations involving X-rays. You may be asked to assist in holding your child still during imaging; if this is necessary the radiographer will direct you in where/how to hold your child in order to obtain the best possible images.
If you prefer, you can choose not to remain in the room as there will be experienced healthcare staff present to look after your child.

All medical procedures carry some risk. With this procedure one ot the risks would be the radiation. Everyone is exposed to naturally occurring background radiation. Every X-ray gives a small additional dose. A skeletal survey is equivalent to a few months’ background radiation, and the CT scan approximately 18 months’. This exposure can increase the lifetime cancer risk, but the risk increase is very small.
All of our equipment is up to date, has routine service checks and is maintained with an ongoing quality assurance programme. Radiation doses are kept as low as practicable.

If you think you may be pregnant when you come to the Radiology Department with your child, please let the X-ray staff (radiographer) know. You will still be allowed into the examination room but will be asked not to hold your child throughout the examination and to watch close by from behind a lead glass screen. This is to protect your unborn child.

As part of the procedure, some kind of photographic record may be made, such as X-rays, clinical photographs or sometimes a video.
You will always be told if this is going to happen. The photograph or record will be kept within your child’s health record and will be held in confidence. This means that it will be seen only by those involved in providing your child with care or those who need to check the quality of care your child has received.

However, the use of photographs and recordings is also extremely important for teaching or medical research. We may request to use your child’s for educational purposes, in which case your written consent will be sought and your child’s personal details will be taken out so that he or she cannot be identified.

When you attend hospital you will be asked for your child’s NHS number and other information, such as your address. Please be patient with this procedure – it is to ensure our records are kept up to date and to protect safety. If you do not know your child’s NHS number, please don’t worry, your child will still receive care.

Please raise any concerns with the ward or department you are in. Ask to speak with the ward sister, matron or department manager. If your concerns cannot be resolved or you wish to make a formal complaint, please call PALS (Patient Advice & Liaison Service) on 0800 783 7328, pick up a PALS leaflet or visit www.esneft.nhs.uk and search for ‘PALS’

If you or a family member has recently been in Colchester Hospital, you can tell us about your experience by clicking on www.esneft.nhs.uk/get-involved/your-views-matter/friends-and-family-test/ or by filling in a ‘Friends & Family’ questionnaire at the hospital.

You can contact your consultant on 01206 747474 or the Radiology department on 01206 742138.