This document has been produced by The Association of Paediatric Radiographers (APR) and The Society and College of Radiographers (SCoR) following publication of Guidance for Radiographers Providing Forensic Radiography Services(1) [2] and Standards for Radiological Investigations of Suspected Non-accidental Injury(2). [2]The aim is to provide further support, practical advice and information to all radiographers involved with imaging suspected Non- Accidental Injury (NAI), Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Death in Infancy/Childhood (SUDI). This guidance should be read alongside further advice relevant to imaging children contained in The Child and the Law: The Roles and Responsibilities of the Radiographer which was published in 2005(3). [2]

Since children are legally considered to be those under 16 years of age in Scotland and under 18 years in the rest of the UK, this document defines children in the same way and this document has relevance for imaging all up to 16 years (Scotland) or 18 years (England, Wales and Northern Ireland). However, in practice it would be extremely rare to perform a skeletal survey on children over the age of two years as other imaging techniques may be initially more suitable.

For a child who may have suffered abuse, imaging may be essential if patterns of trauma that are consistent with NAI are to be detected. In children under the age of two years, a full skeletal survey should always be performed; older children will be discussed on a case-by-case basis(2). [2]

Information on all child deaths (under 18years) will be reviewed by a Child Death Overview Panel(4). [2]This process is mandatory in England, but processes in Scotland, Wales and Northern Ireland will differ. An unexpected child death will be investigated following the principles set out in the Sudden Unexplained Death in Infancy(5). [2]

Although skeletal survey imaging for suspected NAI is a forensic examination there are areas in which practical and clinical considerations will produce additional considerations to those recommended in the Guidance for Radiographers Providing Forensic Radiography Services(1). [2]

Information gained from performing investigations into suspected NAI may present child protection issues not only for the child under investigation but also other siblings. Safeguarding children is the responsibility of all professionals(6). [2]This document offers advice towards a suggested protocol for all staff who are involved with children and their families and/or guardians.