Radiological aspects of child abuse

Abstract

There is no doubt as to the importance of radiological examination in the diagnosis of non-accidental injury to infants and children. A syndrome in which fractures of the long bones were associated with subdural haematoma was first described in 1946 [1]; despite the absence of a suggestive history, it was believed that trauma was the cause of the lesions in the long bones and of the intra-cranial bleeding. The syndrome described was later attributed to ill-treatment by custodians [2, 3]. It was noted that the radiological findings were so bizarre that they would only have been produced by repetitive injuries. Kempe alerted the medical profession and the general public to the problem in a dramatic fashion by coining the term ‘the battered child syndrome’ [4]. Integral parts of that syndrome are that there is often a delay before the child is taken for medical attention and that, frequently, the history is quite inconsistent with the radiological and clinical findings.