The chapter recommends that any child, age 2 or younger, who is suspected of having been abused should have a skeletal survey. For children ages 2- to 5-years-old, skeletal findings are less common, so the need for skeletal surveys in this age group should be based on the specific clinical indicators of abuse. The chapter does not recommend a screening skeletal survey for children older than 5 years; however, at any age, when clinical findings point to a specific site of injury, the customary protocol for imaging that region should be followed. A skeletal survey for suspected abuse should be performed by radiology technologists trained in dealing with children; it should be performed with high detail film-screen combinations. The chapter lists the lesions of high, moderate, and low specificity for child abuse. Other sections of the chapter discuss the interpretation of diagnostic images for indications of abuse in cases of classic metaphyseal fractures, posterior rib fractures, skull fractures, intracranial injury, and thoracoabdominal trauma. Also discussed are the dating of skeletal injuries and the need for additional studies such as a bone scan, additional skeletal views, follow-up skeletal surveys, and head CT or MRI. The chapter concludes with a discussion of differential diagnosis, noting that the most common conditions that may be confused with child abuse are osteogenesis imperfecta and metabolic or infectious bone diseases. A relevant case vignette with follow-up questions is provided. 7 photographs and 34 references