Child Abuse: Imaging and Legal Aspects

  • Claudio Defilippi
  • Roberta Cotti


In 1860, Ambroise Tardieu described in small children a series of traumatic lesions with common characteristics indicating physical maltreatment: 55% of these cases involved children younger than 5 years, and 30% were under 1 year [1]. In 1946, Caffey reported the frequent association of central nervous system injuries with bony lesions. Since then, various terms have been used in reference to this constellation of symptoms, such as Ambroise-Tardieu syndrome, Caffey-Silverman syndrome, parent-infant trauma syndrome, battered child syndrome, and non-accidental-injury (NAI) [2, 3].


Child Abuse Osteogenesis Imperfecta Subdural Hematoma Central Nervous System Injury Abusive Head Trauma 


  1. 1.
    Tardieu A (1860) Etude médico-légale sur les sévices et mauvais traitements exercés sur des enfants. Annales d’hygiène publique et de médecine légale. Paris 13:361–398Google Scholar
  2. 2.
    Caffey J (1946) Multiple fractures in the long bones of infants suffering from chronic subdural hematoma. AJR 56:163–173Google Scholar
  3. 3.
    Kempe CH, Silverman FN, Steele BF et al (1962) The battered-child syndrome. J Am Med Assoc 181:17–24CrossRefGoogle Scholar
  4. 4.
    Lane WG, Dubowitz H, Langenberg P (2009) Screening for occult abdominal trauma in children with suspected physical abuse. Pediatrics 124:1595–1602PubMedCrossRefGoogle Scholar
  5. 5.
    Sonika A, Stein-Wexlera R, Rogersb KK et al (2010) Follow-up skeletal surveys for suspected non-accidental trauma: Can a more limited survey be performed without compromising diagnostic information? Child Abuse Negl 34:804–806CrossRefGoogle Scholar
  6. 6.
    Anilkumar A, Fender L J, Broderick NJ et al (2006) The role of the follow-up chest radiograph in suspected non-accidental injury. Pediatr Radiol 36:216–218PubMedCrossRefGoogle Scholar
  7. 7.
    Williams RL, Connolly PT (2004) In children undergoing chest radiography what is the specificity of rib fractures for the non-accidental injury? Arch Dis Child 89:490–492PubMedCrossRefGoogle Scholar
  8. 8.
    American Academy of Pediatrics (2009) Diagnostic imaging of child abuse. Section on Radiology. Pediatrics 123:1430–1435CrossRefGoogle Scholar
  9. 9.
    Ruess L, O’Connor SC, Quinn WJ et al (2003) An animal model for the classic metaphyseal lesion of child abuse. Pediatr Radiol 33:s112Google Scholar
  10. 10.
    Martino F, Defilippi C, Caudana R (2010) Imaging of pediatric bone and joint trauma. Chapt. 11, Springer Verlag Italia, pp 187–202Google Scholar
  11. 11.
    Carty H, Pierce A (2002) Non-accidental injury: a retrospective analysis of a large cohort. Eur Radiol 12:2919–2925PubMedGoogle Scholar
  12. 12.
    Paterson CR, Burns J, McAllion SJ (1993) Osteogenesis imperfecta: the distinction from child abuse and the recognition of a variant form. Amer J Med Genet 45:87–192CrossRefGoogle Scholar
  13. 13.
    Mendelson KL (2005) Critical review of “temporary brittle bone disease.” Pediatr Radiol 35:1036–1040PubMedCrossRefGoogle Scholar
  14. 14.
    Paterson CR (2009) Vitamin D deficiency rickets and allegations of non-accidental injury. Acta Paediatrica 98:2008–2012.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Claudio Defilippi
    • 1
  • Roberta Cotti
    • 1
  1. 1.Radiology Unit“Regina Margherita” Children’s HospitalTurinItaly

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