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Diagnostic Imaging Of Child Abuse (Visit this link)
POLICY STATEMENT PEDIATRICS Vol. 105 No. 6 June 2000, pp. 1345-1348 AMERICAN ACADEMY OF PEDIATRICS: Diagnostic Imaging of Child Abuse Section on Radiology ABSTRACT The role of imaging in cases of child abuse is to identify the extent of physical injury when abuse occurs, as well as to elucidate all imaging findings that point to alternative diagnoses. 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 years.1-3 The initial recommendation was published in Pediatrics (1991;87:262-264). The concept of child abuse as a medical entity has its origin in the studies of the pediatric radiologist, John Caffey, MD,4 as well as many other specialists in the field of diagnostic imaging. Kempe5 relied heavily on the work of Caffey and his protégé, Frederick Silverman, MD,6 when developing the familiar concept of the "battered child syndrome." When all cases of child abuse and neglect are studied, the incidence of physical evidence documented by diagnostic imaging studies is relatively small. However, imaging studies are often critical in the assessment of infant and young child with evidence of physical injury, and they also may be the first indication of abuse in a child who is seen with an apparent natural illness. When viewed in conjunction with clinical and laboratory studies, imaging findings commonly provide support for allegations of abuse.7 For severely abused infants, the imaging findings alone may form the basis for a diagnosis of the inflicted injury. The role of imaging in cases of suspected abuse is not only to identify the extent of physical injury when abuse has occurred, but also to elucidate all imaging findings that point to alternative diagnoses.8,9 As most conventional imaging studies performed in these settings are noninvasive and entail minimal radiation risks,10 recommendations about imaging should focus on examinations that provide the highest diagnostic yield at acceptable cost.11
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