A skeletal x-ray is an imaging test used to detect fractures, tumors, or conditions that cause wearing away (degeneration) of the bone.

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.

Tell the health care provider if you are pregnant. You must remove all jewelry.

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.

This test is used to detect or diagnose:

• Fractures or broken bone
• Cancer that has spread to other areas of the body
• Osteomyelitis
• 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.

Abnormal findings include fractures, bone tumors, degenerative bone conditions, and osteomyelitis (inflammation of the bone caused by an infection).

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.

Tamisiea DF. Radiologic aspects of orthopedic diseases. In: Mercier LR, ed. Practical Orthopedics. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 16.

Rogers LF. Talianovic MS, Boles CA. Skeletal trauma. In: Grainger RC, Allison D, Adam, Dixon AK, eds.Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 46.