The Value of Radionuclide Bone Scanning in the Early Recognition of Deliberate Child Abuse

Haase, Gerald M.; Ortíz, Victor N.; Sfakianakis, George N.; Morse, Thomas S.

doi:10.1097/00005373-198010000-00009

Cited by 45 publications

(14 citation statements)

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“…Bone scintigraphy has a better detection rate for rib fractures. However, it is less sensitive in detecting skull, spine and metaphyseal fractures [16,17] , the latter as a consequence of the normal high activity seen in the physis of the developing skeleton. As with the skeletal survey, it is important that the bone scan is performed with high technical quality, and in view of the relatively high radiation dose of the bone scan, the investigation should not be undertaken unless the quality of the images is satisfactory [6] .…”

Section: Radiological Investigation Of Suspected Abusementioning

confidence: 99%

Skeletal Aspects of Non-Accidental Injury

Johnson

Bradshaw²

2015

Calcium and Bone Disorders in Children and Adolescents

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Inflicted non-accidental skeletal injuries form a small but important part of the spectrum of child abuse, with the majority of skeletal injuries occurring in children under 2 years of age. Radiology plays a vital role in the detection and evaluation of these skeletal injuries. A thorough detailed radiological evaluation should be undertaken to investigate a child appropriately for a suspected inflicted non-accidental injury to accurately detect and possibly date any injuries and also to exclude normal variants of growth that may mimic fractures. In some cases, the survey may diagnose an underlying metabolic or genetic disorder of the bone that may predispose the child to fracturing. While radiology plays an important role in the dating of injuries, the dating of fractures from radiological appearances is difficult and imprecise. Any fracture may be the result of an inflicted injury or accidental event. Therefore, it is important that all fractures identified are correlated with any relevant clinical history. Certain injuries, such as rib and metaphyseal fractures, require a more specific method of causation and therefore carry a higher degree of suspicion of being the result of an inflicted injury compared with other fracture types, which are relatively non-specific in their mechanisms of causation, such as skull and clavicular fractures. In all cases, correlation with clinical history is mandatory.

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Section: Radiological Investigation Of Suspected Abusementioning

confidence: 99%

Skeletal Aspects of Non-Accidental Injury

Johnson

Bradshaw²

2015

Calcium and Bone Disorders in Children and Adolescents

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“…CML have been described as an iatrogenic trauma after delivery and orthopaedic interventions for clubfeet [8, 18, 50]. In addition, metabolic bone diseases, e.g.…”

Section: Fracturesmentioning

confidence: 99%

Educational paper

Rijn

Sieswerda‐Hoogendoorn

2011

Eur J Pediatr

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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.

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“…A radionuclide bone scan is useful to improve the diagnosis of child abuse and to decrease radiation exposure for those children without skeletal lesions (Tr6ger 1979;Haase et al 1980;Smith et al 1980). The question of whether bone scintigraphy, in cases of suspected child abuse, should be the primary screening modality applied or not is a subject of wide debate (Berdon 1981;Sty and Starchak 1983;Matin 1983;Jaudes 1984).…”

Section: Child Abusementioning

confidence: 99%

Paediatric nuclear medicine

Piepsz

Gordon

Hahn³

1991

Eur J Nucl Med

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Until the 1980s no serious attempts were made to develop paediatric nuclear medicine, as for various reasons many centres were reluctant to perform radionuclide examinations on children. Then two books were published on paediatric nuclear medicine in 1984 and 1985, respectively. In 1987, a group of physicians formed an informal club of paediatricians and nuclear medicine specialists in an effort to improve the relationship and cooperation between these specialties. Carrying out nuclear medicine examinations on children requires a completely different approach than on adults. Suggestions are made and tips given, and the specific problems involved are discussed in detail.

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The Value of Radionuclide Bone Scanning in the Early Recognition of Deliberate Child Abuse

Cited by 45 publications

References 0 publications

Skeletal Aspects of Non-Accidental Injury

Skeletal Aspects of Non-Accidental Injury

Educational paper

Paediatric nuclear medicine

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