Clinical presentations of child abuse are myriad in some children, abuse is suspected from the start however, in many, the presentation is cryptic until traumatic findings are made clinically or by imaging 4 children commonly present with symptoms related to head, abdominal, or extremity trauma children may present with bruising, burns, or evidence of neglect.
Radiology's role in detecting child abuse is profound rts must ensure that their patient is being evaluated thoroughly, promptly and efficiently, while providing the best possible images for detection of abuse all the while, the rt is watching for. In 2009, the american college of radiology (acr) published a set of appropriateness criteria for imaging cases of potential child abuse, although specific protocols may vary among institutions a head ct is commonly ordered for children suspected of being victims of abuse.
In the united states, in 2015, there were 683,000 victims of child abuse, and approximately 1670 children died of abuse and neglect, a rate of 225 per 100,000 children almost 75% of those deaths occurred in children younger than 3 years. There were three children (10%) with normal bone scans who were shown to have injuries radiographically conclusions: skeletal survey and bone scintigraphy are complementary studies in the evaluation of non-accidental injury, and should both be performed in cases of suspected child abuse. Diagnostic imaging of child abuse is based on both advances in imaging technology, as well as a better understanding of the subject based on scientific data obtained during the past 10 years1–3 the initial recommendation was published in pediatrics (199187:262–264.
Skeletal surveys are currently considered standard-of-care for the evaluation of fractures in infants with suspected abuse it has been well described that subtle fractures may be missed and soft tissue and visceral injuries are often undetected using this radiographic modality whole body mri (wb-mri) is mainly used in oncology and infectious disease, however, its application in the field of child abuse pediatrics has not been well studied.
The radiological investigation of suspected physical abuse in children contents we have identified the imaging that should be undertaken when physical abuse of a child is suspected the majority of such cases will involve children under two years old although it has been shown that ct has a greater sensitivity than radiography for the.