A bone survey, also known as a skeletal survey, is a comprehensive diagnostic imaging procedure. It involves taking a series of X-ray images that capture most or all of the bones throughout the body. This provides a detailed overview of the skeletal system, helping to identify abnormalities not visible through a physical examination alone.
Why a Bone Survey is Performed
Medical professionals often order a bone survey to investigate various conditions affecting the skeletal system. One common reason is to detect fractures, especially in cases of suspected fragility fractures or physical abuse in children. These surveys can reveal breaks not immediately obvious or provide a complete picture of injuries across different bones.
Bone surveys also diagnose and monitor various bone diseases. This includes metabolic bone disorders like rickets or osteomalacia, which affect bone mineralization, and Paget’s disease, characterized by abnormal bone remodeling. The survey helps assess the extent and progression of these conditions throughout the skeleton.
Bone surveys also identify bone tumors, whether primary cancers or metastatic cancers that have spread from other parts of the body. For instance, in adults with suspected multiple myeloma, a bone survey frequently looks for characteristic “punched-out” lesions or areas of bone breakdown. This information assists in determining the disease stage and guiding treatment plans.
Bone surveys assess bone age in pediatric cases, useful for evaluating growth disorders. They also evaluate genetic disorders affecting the skeleton, such as osteogenesis imperfecta, a condition that makes bones fragile and prone to fractures. The detailed images help characterize skeletal abnormalities associated with these inherited conditions.
Undergoing a Bone Survey
Patients do not require extensive preparation before a bone survey. You will be asked to remove any jewelry, metal objects, or clothing that might interfere with the X-ray images, such as earrings, glasses, or zippers. A hospital gown is provided if clothing needs to be removed. Inform the staff if you are pregnant or suspect you might be, as special precautions may be necessary.
During the procedure, a radiologic technologist will position you to capture images of various body parts. This involves taking multiple X-rays from different angles, which may require you to lie down, sit, or stand in specific positions against the image detector. A comprehensive survey includes images of the skull, entire spine, chest, pelvis, and major limb bones.
Each X-ray image is captured quickly, within a few seconds. However, because numerous images are taken, the entire bone survey procedure takes longer than a single X-ray, ranging from 20 to 60 minutes. The technologist will provide instructions and may briefly leave the room while X-rays are being taken to minimize their own radiation exposure, but they will remain nearby to monitor you.
The procedure is non-invasive and painless, though holding certain positions for images might cause minor discomfort, especially with an existing injury or limited mobility. After images are taken, a radiologist, a doctor specializing in interpreting medical images, will review them and generate a report. This report is then sent to your referring doctor, who will discuss the findings with you.
Understanding Radiation Exposure
Bone surveys utilize X-rays, which are a form of ionizing radiation. This means they have enough energy to pass through the body and create images of dense structures like bones. While any exposure to radiation carries a small theoretical risk, medical professionals implement strict safety measures to minimize this.
Radiologic technologists are trained to use the lowest possible radiation dose necessary to produce clear diagnostic images. Lead shielding may be used to protect sensitive areas of the body not being imaged, further reducing exposure. X-rays are produced only when the machine is actively on, and no radiation remains in the room or on the patient once the switch is turned off.
The diagnostic benefit of a bone survey outweighs the minimal associated radiation risk. For perspective, the radiation dose from a complete skeletal survey, which may involve around 20 X-rays, is considered moderate. This can be compared to the average background radiation exposure a person receives from natural sources, such as radon gas in homes and cosmic rays, approximately 3 millisieverts (mSv) per year. A typical chest X-ray, for example, is equivalent to about 10 days of natural background radiation. Medical professionals ensure the procedure is clinically justified for your medical needs.