Background The first radiological investigation in children presenting with suspected non-accidental injury is often the skeletal survey. The purpose of a skeletal survey is to provide a standard series of radiographic images that will visualise the entire skeleton. The Royal College of Radiologists in collaboration with the Royal College of Paediatrics and Child Health has published Standards for Radiological Investigations of Suspected Non-accidental Injury. It includes imaging of ten sets of body parts. National target is 100%.

Methods It was a retrospective study. Local practice was checked against National standards. All cases with suspected non-accidental injury under the age of 2 presented within last 3 years were included in this study. Case notes and radiology system was reviewed to collect data. Information was recorded on Proforma & analysed.

Results Total number of children presented during this time period were 27. Out of which 17 were males and 10 were females. Only 18.5% had complete set of x rays as a part of skeletal survey, which is far less than national recommended standards. Skull, Ribs and Spine were missed in more than 30% of cases. Results were discussed locally and causes were identified. Changes were made to practice including all cases should be discussed in multidisciplinary meetings, reports counter signed by pediatric radiologist and awareness of national guidelines.

Conclusion Adherence to protocols in this context is currently poor. Non-accidental injury has medico-legal and children safety aspects. Skeletal survey is an important tool to diagnose suspects accurately which should be used wisely.