Diagnostic Accuracy of Paediatric Skull Radiograph Versus Whole Skeletal Survey in Skeletal Dysplasias And Dysostoses in High Risk Groups

The objective of this study was to evaluate the diagnostic value of skull radiograph alone in young children in screening of skeletal dysplasias and dysostoses in comparison with whole skeletal survey. It is a retrospective study which includes 1000 high risk children who undergone whole skeletal survey. 20 patients were diagnosed as dysplasia/dysostoses out of which 18 patients had skull abnormalities. The sensitivity, specificity, positive predictive value and negative predictive value for skull Xray alone was 90%,100%,100% and 99.8% respectively in making correct diagnosis.Two patients who was diagnosed as chondrodysplasia punctata had no skull abnormalities. In high risk, children rather than doing whole skeletal survey as a routine examination, skull Xray can be done initially as screening tool and in case of abnormal findings or strong clinical suspicion of dysplasias associated with normal skull, rest of the skeletal survey can be considered. This approach will reduce effective radiation(E) dose for those children who are undergoing repeated exposures.