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Pediatric Radiology

, Volume 40, Issue 6, pp 932–938 | Cite as

How to explore and report children with suspected non-accidental trauma

  • Catherine AdamsbaumEmail author
  • Nathalie Méjean
  • Valérie Merzoug
  • Caroline Rey-Salmon
Review

Abstract

Child abuse is a controversial problem of special concern. Recent reports have focused on the broad variability of reporting to child protection services. Radiologists play a key role in the early diagnosis and imaging of suspected inflicted injury. Imaging must be performed and then interpreted with rigour.

The aims of this review are:
  • To review the recent recommended guidelines for imaging in cases of suspicion of abuse. These include a highly detailed complete skeletal survey with centered views, whilst brain CT and/or MRI are mandatory in children younger than 2 years. The use of abdominal imaging is debatable if the child has no symptoms. All siblings younger than 2 years should be assessed in the same way while the diagnosis of abuse is investigated. Body MRI is an interesting modality that remains a “work-in-progress”.

  • To highlight that dating of both brain and skeletal injuries is imprecise. The main point is, however, to determine if the pattern is of “age-different” lesions. This not only provides a strong argument for the diagnosis of abuse, but also indicates repetitive violence with a high risk for further injury and death.

  • To remember that the medical perspective is to protect the child. Thus, radiologists must communicate clearly the suspicion of abuse and the degree of certainty to clinicians to aid reporting or hospitalization.

Keywords

Abuse Fractures Brain Subdural haematoma Radiograph CT MRI Child 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Catherine Adamsbaum
    • 1
    Email author
  • Nathalie Méjean
    • 2
  • Valérie Merzoug
    • 2
  • Caroline Rey-Salmon
    • 3
  1. 1.Radiology Department, Pediatric ImagingParis Descartes University, St Vincent de Paul HospitalParis Cedex 14France
  2. 2.Radiology Department, Pediatric ImagingSt Vincent de Paul HospitalParis Cedex 14France
  3. 3.Medico-Judicial UnitHôtel Dieu Hospital, AP-HPParisFrance

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