Background: ACR guidelines for routine skeletal survey for child abuse recommend only AP radiographs of the long bones; however, many institutions add lateral radiographs. A skeletal survey is a series of radiographs, performed systematically to cover the entire skeleton or the anatomic regions appropriate for the clinical indications. A typical skeletal survey includes bilateral anteroposterior (AP) and posteroan • Children older than 5 years of age generally do not benefit from the skeletal survey study. References 1. American Academy of Pediatrics Section on Radiology. Diagnostic imaging of child abuse. Pediatrics. 2000; 105(6): 1345-1348. 2. American College of Radiology. ACR Practice Guidelines for Skeletal Surveys in Children. Revised 2006. X-ray skeletal survey 9 ??? or American Academy of Pediatrics guidelines, some add lateral radiographs of the Appropriateness Criteria® ACR Appropriateness Criteria® ? ACR Appropriateness Criteria® ACR Appropriateness Criteria® Suspected Physical Abuse-Child ACR High Specificity Features on Plain Film of Non-Accidental Injury Adam A Dmytriw1,2, Skeletal Survey ACR Guidelines: AP / lateral skull (+ Townes if suspicious of occipital fracture) Cook D, Fitzgerald M, Ditchfield MR. Complementary use of radiological skeletal survey and bone Repeat Survey . is Indicated In 3 Weeks whenever: •Abuse is still supected after initial evaluation • Complete Skeletal Survey . Indicated for. Sibling. when: •Sibling is twin of primary patient •Sibling is < 1 year old. Skeletal Surveys • Head and C-spine CT Indicated when: •Intracranial injury suspected by history (e.g. apnea acr-spr practice guideline for skeletal surveys in children. acr-spr practice guideline for the performance of pediatric fluoroscopic contrast enema examinations acr-spr practice guideline for the performance and interpretation of pediatric magnetic resonance imaging (mri) acr practice guidelines and technical standards ACR Practice Guideline for th