Background and Aim of the Audit:
There were 108 child maltreatment cases per 1000 children in 2010 in Canada. The highest rates of investigation involve children < 2 years old.  Radiologists play pivotal roles in identifying inflicted injuries. Standardizing the imaging protocol is key to ensuring consistent care and preventing misses, which can have devastating consequences.  The ACR and SPR collaboratively set out pediatric SS performance and interpretation practice parameters in 2016.
 
This audit aims to assess adherence to the inclusion of all recommended views in SS performed in patients < 2 years old presenting with known or suspected non-accidental trauma.

Audit Target
100%

Methods
100 SS reports for suspected child maltreatment were reviewed.  SS for other indications and follow-up surveys were excluded. In accordance with our institutional policy, we also assessed if SS were double-read by two Radiologists.   

Results  
Ninety-eight SS were adherent to ACR-SPR guidelines. Ninety-eight SS were double-read. 

Conclusions
While close to meeting the audit target, there is still room for improvement.  This audit proved valuable in identifying barriers to adherence.

Adherence to standard views in skeletal surveys performed on children with known or suspected abuse