A skeletal x-ray is an imaging test used to detect fractures, tumors, or conditions that cause wearing away (degeneration) of the bone.
How the test is performed
The test is performed in a hospital radiology department or in the health care provider’s office by an x-ray technologist. The test may be done while you lay on a table or stand in different positions in front of the x-ray machine, depending on the bone that is injured. You may be asked to change position so that different x-ray views can be taken.
The x-ray particles pass through the body. A computer or special film records the images that are created.
Structures that are dense (such as bone) will block most of the x-ray particles, and will appear white. Metal and contrast media (special dye used to highlight areas of the body) will also appear white. Structures containing air will be black and muscle, fat, and fluid will appear as shades of gray.
How to prepare for the test
Tell the health care provider if you are pregnant. You must remove all jewelry.
How the test will feel
The x-rays themselves are painless. However, changing positions and placing the injured area in the necessary position may be uncomfortable. If the entire skeleton is being imaged, the test usually takes 1 hour or more.
Bone damage due to trauma (such as an auto accident) or degenerative conditions
A skeletal x-ray is often used in children suspected of being abused.
What abnormal results mean
Abnormal findings include fractures, bone tumors, degenerative bone conditions, and osteomyelitis (inflammation of the bone caused by an infection).
What the risks are
There is low radiation exposure. X-rays machines are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits.
Pregnant women and children are more sensitive to the risks of the x-ray. A protective shield may be worn over areas not being scanned.
Clement J. Basic imaging techniques in the adult. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 13, section A.
Clement J. Imaging consideration in the skeletally immature patient. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 13, section B.
Renner JB. Conventional radiography in musculoskeletal imaging. Radiol Clin North Am. 2009 May;47(3):357-72.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.