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X-Rays Bone Survey Limited

Also known as

Limited Skeletal Survey

A bone survey Limited is a defined set of radiographs obtained to assess the bones at areas of interest in the body. This procedure is a series of images that cover the problematic bones throughout the anatomic regions appropriate for the cynical indications. These are commonly ordered by child protection teams who suspect non-accidental abuse or metastasis or bone disease such as multiple myeloma. A CT scan and MRI are also conducted to help look at a bone abnormality in multiple myeloma. However, for non-accidental injury, an X-ray is preferred due to the lower radiation dose to pediatric patients.
A bone survey limited x-ray identifies focal and diffuse abnormalities of the bone structure accurately. It differentiates them from developmental changes and other anatomic variants. A typical bone survey may include front to back (AP) and back to front (PA) images of all major bones. However, a limited bone survey will only be targeted towards the symptomatic areas of your skeleton. Your doctor may order this procedure as part of the evaluation for some suspected condition that involves specific bones in your body. For example, suppose NIA child abuse is suspected. In that case, the doctor may order x-rays of the humerus, tibia, femur and wrist since they are the most common fractures in such patients. For congenital disorders, they may request a bone survey of the forearms and wrists to calculate a bone age which helps confirm diagnoses or determine the extent of disease in infants and children. In adults, abnormal blood tests may indicate certain cancers (such as multiple myeloma). The doctor may request a limited bone survey to establish whether there is bone involvement. A bone survey limited can be of any set of these bones:
  • Torso
  • Chest AP
  • Ribs (oblique) (left and right)
  • Abdomen and pelvis AP
  • Spine (whole spine lateral)
  • Upper limbs (each)
  • Humerus AP
  • Elbow lateral
  • Forearm AP
  • Wrist lateral
  • Hand DP
  • Lower limbs (each)
  • Femur AP
  • Knee (lateral)
  • Tib/fib AP
  • Ankle lateral
  • Foot DP
  • Your doctor may order a bone survey limited x-ray if you are suspected of having:
  • Physical child abuse
  • Dysplasias of the bone
  • Infections that may have spread
  • Metastatic bone disorder
  • Multiple myeloma
  • WBC granuloma
  • Imperfect bone formation
  • Paget's disease
  • Metabolic bone disease
  • Rickets
  • Scurvy
  • Hyperthyroidism
  • Body dysmorphic disorder
  • Metabolic disorder
  • Polyarticular arthropathy
  • This procedure does not require any special preparation. However, be sure to alert the staff if you may be pregnant. You will be asked to change into a hospital gown. Since the bone survey requires head-to-toe radiographs, your clothes may interfere with the images. A lead shield for radiation protection may be placed over the body parts that are not undergoing an x-ray.
    A typical bone survey limited consists of around twenty plain X-rays (radiographs) of your entire body. Specifically, the examination includes radiographs of the skull, chest, abdomen, spine, arms,and legs. The procedure will usually be performed with you standing up, seated or lying down in various positions against the image detector. These will allow the x-ray technician to be able to obtain a variety of images of your bones. If you have an injury, had surgery and are in pain, you may be given foam pieces or a neck brace for support. If you cannot stand for an x-ray, it will be taken while sitting down.
    After the radiographs are obtained, they are usually sent to a radiologist who will interpret and send a written report to your doctor. The doctor will then discuss your x-ray report with you. If the procedure were performed to evaluate multiple myeloma or another form of cancer, the radiology report would detail whether the disease causes bone abnormalities. In patients who have been treated for multiple myeloma, bone surveys should be repeated to see if the disease has responded to treatment or if it has progressed further. If child abuse is suspected, the report would state how old fractures in the bones x-rayed are and whether they indicate non-accidental trauma. If a congenital syndrome is suspected, the radiology report will describe whether the bones' appearance suggests a particular syndrome.