Title

Follow-up skeletal surveys in suspected child abuse

UMMS Affiliation

Department of Radiology; Department of Orthopedics

Publication Date

10-1-1996

Document Type

Article

Subjects

Bone and Bones; Child Abuse; Female; Fractures, Bone; Humans; Infant; Infant, Newborn; Male

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

OBJECTIVE: The purpose of this study was to assess the additional yield of a repeat skeletal survey in identifying and dating skeletal injury for cases in which child abuse was strongly suspected. MATERIALS AND METHODS: Twenty-three infants and toddlers strongly suspected of being physically abused on the basis of findings on the initial skeletal survey, other imaging studies, history, or physical examination underwent a follow-up examination approximately 2 weeks after the initial examination. The high-detail imaging system included a single-emulsion, single-screen combination with a low-absorption carbon-fiber cassette. The skeletal survey protocol entailed tightly collimated anteroposterior views of the appendicular skeleton and anteroposterior and lateral views of the axial skeleton. Between the two studies, all children were in Department of Social Services custody or living in a safe home. RESULTS: The follow-up skeletal survey yielded additional information regarding skeletal injury in 14 (61%) of 23 cases. Follow-up study increased the number of definite fractures detected from 70 to 89 (27%) (p = .005). Most of these additional injuries were classic metaphyseal lesions or rib fractures. In 13 of the 70 fractures previously detected, the follow-up skeletal survey also provided important information about the age of those injuries. CONCLUSION: When child abuse is strongly suspected on the basis of the findings on the initial skeletal survey, other imaging studies, history, or physical examination, a follow-up skeletal survey is recommended to provide a through and accurate assessment of osseous injuries.

Rights and Permissions

Citation: AJR Am J Roentgenol. 1996 Oct;167(4):893-6.

DOI of Published Version

10.2214/ajr.167.4.8819377

Related Resources

Link to article in PubMed

Journal/Book/Conference Title

AJR. American journal of roentgenology

PubMed ID

8819377