Imaging investigations when there are safeguarding concerns

Please note: If you are pregnant or think you may be, please inform the x-ray staff.

In some situations, doctors may want to take x-rays or other images of a child to assess possible injuries. Imaging may include a full skeletal survey, CT (computed tomography) brain scan, MRI (magnetic resonance imaging) head and spine and US (ultrasound). The doctor in charge of your care will explain the reasons why these scans are required and will be happy to answer any questions you may have regarding this leaflet.

About the tests

Skeletal survey

The skeletal survey is a series of x-rays of your child’s bones. It is used to identify any underlying problem with bone structure and identify any unknown fractures which may be healing or require further treatment.

The survey is carried out in two visits to the radiology department, and conducted by experienced radiographers who are skilled in dealing with children who will help you and your child through the procedure.

On the first visit, 20 to 25 images are taken. Your child will need to be still and it may take up to an hour to complete the survey. A nurse will accompany you and assist the radiographer in holding your child. If your child has a favourite toy or comforter, please bring this with you. The radiographers may be able to time the survey to take place after a baby has had a recent feed. On occasion we will prescribe a mild sedative to an older child to help them relax. A preliminary report is usually available within 24 to 48 hours after the series of x-rays have been reviewed by two radiologists.

A second visit is required 11 to 14 days after the first set of images have been taken, which completes the skeletal survey. Two chest/ rib views are undertaken. Sometimes, further x-rays are needed.

CT brain scan

A CT scan looks at the bony skull and the brain inside. The scanner looks like a giant polo mint. Your child will need to lie down on the scanning bed/ table so that they can be positioned in the centre of the scanner. The actual scan takes only a few minutes; most children will lie still long enough for the scan to take place.

Occasionally a medicine can be given to calm or relax the child – this is known as sedation.

The scan is reviewed by a consultant radiologist, and a report is sent to the doctor looking after your child. The information will be shared with you as soon as it is available.

MRI scans

It may be necessary to perform an MRI of the head and spine. This scan uses a magnet to make a picture of part of the body. Unlike the CT, the MRI does not use x-rays, so there is no risk of radiation exposure.

The MRI scanner looks like a giant polo mint and the centre feels like a tunnel. A scan will take 20 to 30 minutes; some babies and young children may find it difficult to keep still. It may be appropriate to perform the MRI under sedation. The anaesthetist will talk to you in more detail before giving sedation. Your child will be carefully monitored during the scan.

The scan will be reviewed by a consultant radiologist, and the results are sent to the doctor in charge of your child’s care. This information will be shared with you when it becomes available.

Ultrasound scans

Ultrasound is good for looking at the soft parts of the body that may not show up well on an x-ray or CT scan. First, a gel is put on the skin, then the picture is made by gently moving a smooth probe over the child’s skin. It is similar to the baby scan expectant mothers have during their pregnancy.

The procedure is carried out by a consultant radiologist. The report is sent to the consultant paediatrician. The information will be shared with you when it is available.

Risks of these tests

Skeletal surveys and CT brain scans use ionising radiation (x-rays). The radiation dose received during a skeletal survey is equivalent to a few months natural background radiation, and carries a minimal risk (less than 1 in 100,000) of inducing cancer in later life. The radiation dose received during a CT brain scan is equivalent to 18 months natural background radiation, and carries a low risk (about 1 in 5,000) of inducing cancer in later life. These risks should be compared to the natural lifetime risk of cancer, which is about 1 in 3.

MRI and ultrasound scans do not use ionising radiation, so there is no known cancer risk associated with these procedures. For these reasons, careful consideration is given to performing a CT scan by the medical team looking after your child.