Radiology in suspected non-accidental injury: Theory and practice in the Netherlands

Rijn, Rick R. van; Kieviet, Noera; Hoekstra, Robert; Nijs, H. G. T.; Bilo, Robert A. C.

doi:10.1016/j.ejrad.2008.02.014

Cited by 23 publications

(13 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…34 Other studies in the USA, UK and Netherlands showed similar results. 31,[35][36][37] For the reporting radiologist, it is important that, just like in all other cases, the radiology request clearly states the indication for the skeletal survey, including details on current clinical problems, mode of presentation and relevant (medical-, family-and social) history. 32 Furthermore, it is important to consult with colleagues and convey any concerns.…”

Section: Discussionmentioning

confidence: 99%

Paediatric femur fractures at the emergency department: accidental or not?

Konijnenburg¹,

Vrolijk-Bosschaart²,

Bakx³

et al. 2016

BJR

View full text Add to dashboard Cite

Only a small proportion of all paediatric fractures is caused by child abuse or neglect, especially in highly prevalent long bone fractures. It can be difficult to differentiate abusive fractures from non-abusive fractures. This article focuses on femoral fractures in young children. Based on three cases, this article presents a forensic evidence-based approach to differentiate between accidental and non-accidental causes of femoral fractures. We describe three cases of young children who were presented to the emergency department because of a suspected femur fracture. Although in all cases, the fracture had a similar location and appearance, the clinical history and developmental stage of the child led to three different conclusions. In the first two cases, an accidental mechanism was a plausible conclusion, although in the second case, neglect of parental supervision was the cause for concern. In the third case, a non-accidental injury was diagnosed and appropriate legal prosecution followed. Any doctor treating children should always be aware of the possibility of child abuse and neglect in children with injuries, especially in young and non-mobile children presenting with an unknown trauma mechanism. If a suspicion of child abuse or neglect arises, a thorough diagnostic work-up should be performed, including a full skeletal survey according to the guidelines of the Royal College of Radiologists and the Royal College of Paediatrics and Child Health. In order to make a good assessment, the radiologist reviewing the skeletal survey needs access to all relevant clinical and social information.

show abstract

Section: Discussionmentioning

confidence: 99%

Paediatric femur fractures at the emergency department: accidental or not?

Konijnenburg¹,

Vrolijk-Bosschaart²,

Bakx³

et al. 2016

BJR

View full text Add to dashboard Cite

show abstract

“…Posterior rib fractures, although rare and only in cases of difficult labour or large babies, have been reported after vaginal delivery [68]. Rib fractures are well described in metabolic bone disease of prematurity or other metabolic disorders and skeletal dysplasias [16, 59].…”

Section: Fracturesmentioning

confidence: 99%

Educational paper

Rijn

Sieswerda‐Hoogendoorn

2011

Eur J Pediatr

View full text Add to dashboard Cite

Fractures are reported to be the second most common findings in child abuse, after skin lesions such as bruises and contusions. This makes careful interpretation of childhood fractures in relation to the provided clinical history important. In this literature review, we address imaging techniques and the prevailing protocols as well as fractures, frequently seen in child abuse, and the differential diagnosis of these fractures. The use of a standardised protocol in radiological imaging is stressed, as adherence to the international guidelines has been consistently poor. As fractures are a relatively common finding in childhood and interpretation is sometimes difficult, involvement of a paediatric radiologist is important if not essential. Adherence to international guidelines necessitates review by experts and is therefore mandatory. As in all clinical differential diagnoses, liaison between paediatricians and paediatric radiologists in order to obtain additional clinical information or even better having joint review of radiological studies will improve diagnostic accuracy. It is fundamental to keep in mind that the diagnosis of child abuse can never be solely based on radiological imaging but always on a combination of clinical, investigative and social findings. The quality and interpretation, preferably by a paediatric radiologist, of radiographs is essential in reaching a correct diagnosis in cases of suspected child abuse.

show abstract

“…Kleinman et al [5] surveyed radiologists at paediatric health-care facilities in the USA and found that imaging protocols varied from the recommended guidelines. In 2007, Schmit et al [29] [30] and van Rijn et al [31] retrospectively examined skeletal surveys and found many differences in the number and quality of radiographs performed. They concluded that the available guidelines are generally not implemented in clinical practice.…”

Section: Imaging Protocolmentioning

confidence: 99%