{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:48:08Z","timestamp":1777355288350,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Medical Radiation Sci"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Skeletal surveys are a series of X\u2010ray images used to identify bone injuries in suspected cases of non\u2010accidental injury (NAI). This study evaluates effective radiation doses and associated risks of radiation exposure from skeletal surveys that were performed on children under 5\u2009years of age at a tertiary paediatric hospital in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Radiographic exposure records were retrospectively analysed for 362 initial and follow\u2010up skeletal surveys conducted between 2018 and 2023 for suspected physical abuse. Effective doses and organ absorbed doses were calculated using PCXMC software against background equivalent radiation times (BERT) in Australia. Nominal risks of radiation\u2010induced cancer induction and fatality were estimated using Biologic Effects of Ionising Radiation (BEIR) VII risk coefficients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean effective dose was 0.24\u2009mSv for initial examinations and 0.18\u2009mSv for follow\u2010up examinations, equivalent to 52 and 38\u2009days of background radiation exposure, respectively. The averaged nominal risks associated with an initial skeletal survey are 9.3 in 10,000 for cancer induction, and 3.1 in 10,000 for fatal cancer. Variability of radiation effective dose is demonstrated, with an interquartile range of 0.17\u20130.30\u2009mSv and an overall range of 0.04\u20130.76\u2009mSv for initial skeletal surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radiation doses for initial and follow\u2010up skeletal surveys performed for suspected NAI were determined from a large set of examinations. Several radiation risk metrics have been presented to assist healthcare professionals and caregivers in understanding the associated risks of radiation exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmrs.70045","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T05:23:52Z","timestamp":1764912232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiation Dose and Risk in the Radiological Investigation of Suspected Non\u2010Accidental Injury (\n                    <scp>NAI<\/scp>\n                    )"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5116-9885","authenticated-orcid":false,"given":"Tooba","family":"Zaidi","sequence":"first","affiliation":[{"name":"Department of Medical Imaging Perth Children's Hospital  Nedlands Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1473-1379","authenticated-orcid":false,"given":"Rikki","family":"Nezich","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Perth Children's Hospital  Nedlands Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Australian Institute of Health and Welfare \u201cChild Protection Australia 2020\u201021 \u201dReport No.: CWS 90. 2023 accessed 15 July 2025 https:\/\/www.aihw.gov.au\/reports\/child\u2010protection\/child\u2010protection\u2010australia\u20102020\u201021."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2016.11.016"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2017.01.036"},{"key":"e_1_2_9_5_1","unstructured":"Royal College of Radiologists Society of Radiographers \u201cThe Radiological Investigation of Suspected Physical Abuse in Children \u201d(Royal College of Radiologists 2018) cited 21 September 2025 https:\/\/www.rcr.ac.uk\/media\/nznl1mv4\/rcr\u2010publications_the\u2010radiological\u2010investigation\u2010of\u2010suspected\u2010physical\u2010abuse\u2010in\u2010children\u2010revised\u2010first\u2010edition_november\u20102018.pdf."},{"key":"e_1_2_9_6_1","unstructured":"The Royal Australian and New Zealand College of Radiologists \u201cGuideline for Imaging of Suspected Non\u2010Accidental Injury \u201dRANZCR 2022 accessed 25 June 2023 https:\/\/www.ranzcr.com\/college\/document\u2010library\/guideline\u2010for\u2010imaging\u2010of\u2010suspected\u2010non\u2010accidental\u2010injury."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102020\u2010319065"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247\u2010020\u201004945\u20101"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.07.064"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.632"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247\u2010022\u201005456\u2010x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.01.017"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102018\u2010316286"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247\u2010022\u201005477\u20106"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.269"},{"key":"e_1_2_9_16_1","unstructured":"Ashford and St. Peter's Hospitals NHS Foundation Trust \u201cSkeletal Survey for Non\u2010Accidental Injury Guideline \u201d2023 cited 24 September 2025 https:\/\/ashfordstpeters.net\/Guidelines_Paediatrics\/Skeletal%20Survey%20for%20NAI%20Guideline%20Apr%202023.pdf."},{"key":"e_1_2_9_17_1","unstructured":"Department of Families Fairness and Housing \u201cFramework for Trauma\u2010Informed Practice \u201d2021 Department of Families Fairness and Housing. Melbourne Australia: State Government of Victoria cited 21 September 2025 https:\/\/www.dffh.vic.gov.au\/publications\/framework\u2010trauma\u2010informed\u2010practice."},{"key":"e_1_2_9_18_1","unstructured":"B. F.Wall R.Haylock J. T. M.Jansen M. C.Hillier D.Hart andP. C.Shrimpton \u201cRadiation Risks From Medical X\u2010Ray Examinations as a Function of the Age and Sex of the Patient \u201d(HPA Centre for Radiation Chemical and Environmental Hazards 2011) Report No.: HPA\u2010CRCE\u2010028 cited 2 November 2025 https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/340147\/HPA\u2010CRCE\u2010028_for_website.pdf."},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.icrp.2007.10.003"},{"key":"e_1_2_9_20_1","unstructured":"M.TapiovaaraandT.Siiskonen \u201cPCXMC A Monte Carlo Program for Calculating Patient Doses in Medical X\u2010Ray Examinations \u201d(2nd Ed.). Report STUK\u2010A139 2008. 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