Which radiological investigations should be performed to identify fractures in suspected child abuse?

Kemp, Alison; Butler, Alan; Morris, Stephen A.; Mann, Marilynne; Kemp, Kenneth W.; Rolfe, Kim; Sibert, Jonathan Richard; Maguire, Sabine

doi:10.1016/j.crad.2006.03.017

Cited by 107 publications

(66 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Normally, there is high tracer uptake in the skull base, orbits, nasal region, temporomandibular joints, and cranial sutures, whereas absence of uptake may be seen in the region of the anterior fontanelle. As growth centers close, the biodistribution of 99m Tc-MDP gradually reaches the adult pattern (76)(77)(78)(79)(80)(81)(82)(83)(84). One special indication in this age group is evaluation for skeletal injury in suspected cases of child abuse (85).…”

Section: Bonementioning

confidence: 99%

“…management of the patient. Skeletal scintigraphy is established as a study complementary to the radiographic skeletal survey, and some authors have recommended that both studies be done (82,83). The sensitivity of standard 99m Tc-MDP skeletal scintigraphy for the detection of fractures varies greatly depending on the location of the lesion (Fig.…”

Section: Trauma and Nonaccidental Injurymentioning

confidence: 99%

See 1 more Smart Citation

Nuclear Medicine in the First Year of Life

Treves¹,

Baker²,

Fahey³

et al. 2011

J Nucl Med

View full text Add to dashboard Cite

Learning Objectives: On successful completion of this activity, participants should be able to describe, for children less than 1 y old, (1) the wide variety of nuclear medicine indications; (2) the nuclear medicine studies, relative to other imaging methods, that can provide the highest diagnostic yield; (3) how to obtain high-quality nuclear medicine examinations at the lowest radiation exposures; (4) how growth and development affect the appearance, and therefore the interpretation, of nuclear medicine images; and (5) special care needed, such as patient preparation, immobilization, distraction techniques, environment, sedation or general anesthesia, imaging techniques, image processing, and presentation of results.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNM designates each JNM continuing education article for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only credit commensurate with the extent of their participation in the activity.For CE credit, participants can access this activity through the SNM Web site (http://www.snm.org/ce_online) through June 2012.Nuclear medicine has an important role in the care of newborns and children less than 1 y old. Patients in this age group present with a spectrum of diseases different from those of older children or adults. These patients can benefit from the full range of nuclear medicine studies. In these young children, nuclear medicine studies are more likely to be used to evaluate a wide range of congenital conditions but also can be helpful for evaluating acquired conditions such as infection, cancer, and trauma. This review first will cover the general aspects of nuclear medicine practice with these patients, including the special considerations that can help achieve successful diagnostic imaging. These topics will include clinical indications, imaging technology, instrumentation, software, positioning and immobilization, sedation, local and general anesthesia, radiopharmaceutical doses, radiation risk, and dose reduction. The review then will discuss the specific nuclear medicine studies that typically are obtained in patients in this age group. With extra care and attention to the special needs of this population, nuclear medicine departments can successfully study patients less than 1 y old.

show abstract

Section: Bonementioning

confidence: 99%

Section: Trauma and Nonaccidental Injurymentioning

confidence: 99%

Nuclear Medicine in the First Year of Life

Treves¹,

Baker²,

Fahey³

et al. 2011

J Nucl Med

View full text Add to dashboard Cite

show abstract

“…Its primary use is in the identifi cation of subtle rib fractures, but it is not particularly good at demonstrating epiphyseal and metaphyseal fractures, as these areas are obscured by normal physiologic activity and high periphyseal uptake of radiopharmaceutical [ 11 ]. Skull fractures are notoriously diffi cult to visualize on routine bone scans [ 12 ]. Equally important, bone scans require sedation and expose the child to a relative high radiation dose [ 13 ].…”

Section: Imaging Techniquesmentioning

confidence: 99%

Non-accidental Trauma

Sanchez

Grasparil

Coulter

2014

Pediatric Orthopedic Imaging

View full text Add to dashboard Cite

show abstract

“…Bone scans can also be diagnostic in cases of suspicion when there is a negative skeletal survey and there is a high index of suspicion. Repeat radiographs a few weeks later can also be ordered when initial scans were negative and there is still suspicion [5].…”

Section: Orthopaedic Manifestations Of Abusementioning

confidence: 99%

“…Diaphyseal fractures can be transverse, oblique, or spiral. In general, metaphyseal fractures conforming to the classic metaphyseal lesion are less common than diaphyseal fractures, but when present, are highly specific for infant abuse [5,12,25]. Physeal fractures conforming to the Salter-Harris classification are uncommon, except for transphyseal fractures of the distal humerus [10].…”

Section: Orthopaedic Manifestations Of Abusementioning

confidence: 99%