Purpose or Case Report: The purpose is to evaluate how well hospitals comply with ACR-SPR guidelines for skeletal surveys in the cases of possible child abuse.
Methods & Materials: This is a retrospective study (Jan-Sept 2016). We reviewed all outside hospital skeletal surveys for suspected child abuse in which our child protective team was consulted. We documented the views obtained compared to the minimum 21 radiographs recommended by the ACR-SPR, as well as technique.
Results: 117 (23 different hospitals) studies of 112 children, age 5 days to 6 years (mean age 11 months) were reviewed. 58/117 studies (49.6%) did not follow ACR-SPR guidelines. The most common reasons for noncompliance were exclusion of the following: oblique views of ribs 46/117 (39.3%), lateral cervical spine 38/117 (32.5%), dedicated lateral thoracic spine 33/117 (28.2%), and collimated AP views of each of the long bones 33/117 (28.2%).
Conclusions: ACR-SPR guidelines for skeletal survey for suspected child abuse are often not followed. More education and guidance is required to improve compliance with the ACR-SPR guidelines in nonchildren hospitals where the majority of pediatric imaging is performed.