Lead poisoning is suspected in patients with characteristic symptoms. However, because symptoms are often nonspecific, diagnosis of lead poisoning is often delayed. Evaluation includes complete blood count and measurement of serum electrolytes, blood urea nitrogen (BUN), serum creatinine, plasma glucose, and PbBs. An abdominal x-ray should be taken to look for lead particles, which are radiopaque. X-rays of long bones are taken in children. Horizontal, metaphyseal lead bands representing lack of bone remodeling and increased calcium deposition in the zones of provisional calcification in children’s long bones are somewhat specific for poisoning with lead or other heavy metals but are insensitive. Normocytic or microcytic anemia suggests lead toxicity, particularly when the reticulocyte count is elevated or red blood cell basophilic stippling occurs; however, sensitivity and specificity are limited. Diagnosis is definitive if PbB is ≥ 5 mcg/dL (0.24 micromol/L).