The yield of high-detail radiographic skeletal surveys in suspected infant abuse

Barber, Ignasi; Peréz-Rosselló, Jeannette M.; Wilson, Celeste R.; Kleinman, Paul K.

doi:10.1007/s00247-014-3064-3

Cited by 77 publications

(43 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Young victims of AHT frequently have occult fractures that may be detected on SS. 6,7 One study identified occult fractures in 34% of infants <1 year old with suspected AHT who underwent SS. 6 Another study found that 29% of hospitalized infants <1 year old with unwitnessed head trauma who underwent SS had occult fractures.…”

mentioning

confidence: 99%

“…6,7 One study identified occult fractures in 34% of infants <1 year old with suspected AHT who underwent SS. 6 Another study found that 29% of hospitalized infants <1 year old with unwitnessed head trauma who underwent SS had occult fractures. 7 Identifying occult fractures that do not match the reported history of trauma can confirm a suspicion of abuse and may also provide additional information on the timing of the injury.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Development of Guidelines for Skeletal Survey in Young Children With Intracranial Hemorrhage

Paine

Scribano²,

Localio

et al. 2016

Pediatrics

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: As evidenced by the variation and disparities in evaluation, there is uncertainty in determining which young children with intracranial hemorrhage (ICH) should undergo evaluation with skeletal survey (SS) for additional injuries concerning for abuse. We aimed to develop guidelines for performing initial SS in children <24 months old presenting with ICH by combining available evidence from the literature with expert opinion.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Development of Guidelines for Skeletal Survey in Young Children With Intracranial Hemorrhage

Paine

Scribano²,

Localio

et al. 2016

Pediatrics

View full text Add to dashboard Cite

show abstract

“…Our results indicate that physical abuse of children younger than three years was undoubtedly confirmed in only 5% of 98 suspected cases. This is relatively low compared to other reports because there was no consistent approach to the investigation of these children [15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 61%

“…Large studies cite unknown or inconsistent history of mechanism of injury as a major indicator of abuse [1,2,3,[15][16][17][18][19][20]. In most of our cases, the mechanism of injury was either unknown or it was stated to be self-injury.…”

Section: Discussionmentioning

confidence: 87%

Social, clinical and radiological characteristics of physical abuse of children up to 3 years of age hospitalized in a tertiary health institution

et al. 2017

View full text Add to dashboard Cite

Introduction/Objective Child abuse is a significant public health problem in modern society. Many cases of violence against children remain undetected. Serbia has no official protocols for medical examination of abused children. The aim of the study is an analysis of the social, clinical and radiological characteristics of physical abuse of children under three years of age that required hospital treatment. Methods This retrospective study included 98 physically injured children admitted to the University Children's Hospital in the period from 2013 to 2015, with suspected physical abuse. In addition to the history of injuries, complete clinical examinations and standard laboratory analyses were performed in all children, as well as X-ray examination in children with apparent or suspected skeletal injury. Ultrasound examination and computerized tomography or magnetic resonance imaging were performed in selected patients. Final diagnosis of abuse was established by multidisciplinary assessment team. The children were divided into two groups-those with proven and those with suspected abuse. Results Most of 98 children who were suspected of being abused (92%) were from one or both unemployed parents, 68% were male, 60% were first-born, and 44% younger than one year. Ninety-two percent of the children had skeletal fractures, 19% of whom had two or more fractures. The commonest fracture was a linear skull fracture, which was detected in 51% of the cases. Abuse was confirmed in only five of 98 suspected cases. Conclusion Among the known social risk factors for abuse of children, the low economic status of the family was the most frequent one in our analyzed sample. The most common injury is a linear skull fracture. A national guideline for medical investigating of abused children is required.

show abstract

“…Although fractures limited to sites other than the long bones, ribs, skull, and clavicles are rare, the additional radiation exposure and cost of obtaining radiographs of the spine, pelvis, hands, and feet may outweigh their potential benefits, and consideration may be given to eliminating these views from routine skeletal surveys performed to evaluate a child for suspected abuse [9] . Supplementary views should include a lateral view of any fractures and coned-down views of the metaphyses when the features are suggestive of a fracture or otherwise equivocal findings are obtained [10,11] .…”

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

View full text Add to dashboard Cite

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.

show abstract

The yield of high-detail radiographic skeletal surveys in suspected infant abuse

Abstract: Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population.

Cited by 77 publications

References 42 publications

Development of Guidelines for Skeletal Survey in Young Children With Intracranial Hemorrhage

Development of Guidelines for Skeletal Survey in Young Children With Intracranial Hemorrhage

Social, clinical and radiological characteristics of physical abuse of children up to 3 years of age hospitalized in a tertiary health institution

Skeletal Aspects of Non-Accidental Injury

Contact Info

Product

Resources

About