Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal

被引：29

作者：

Bennett B.L. ^{[1
]}

Chua M.S. ^{[1
]}

Care M. ^{[2
]}

Kachelmeyer A. ^{[1
]}

Mahabee-Gittens M. ^{[1
]}

机构：

[1] Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

[2] Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

来源：

BMC Research Notes | / 4卷 / 1期

关键词：

Child Abuse; Follow-up; Non-accidental trauma; Skeletal survey;

D O I：

10.1186/1756-0500-4-354

中图分类号：

学科分类号：

摘要：

Objective. The AAP recommends that a follow-up skeletal survey be obtained for all children < 24 months of age who are strongly suspected to be victims of abuse. The objective of the current study was to evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations when the initial skeletal survey is normal. Methods. A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were < 24 months of age and received initial and follow-up skeletal surveys within 56 days were enrolled in the study. Children with a negative initial skeletal survey were included for further analysis. Results: Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7); the mean number of days between skeletal surveys was 18.7 (SD 10.1). Four children (8.5%) had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75%) had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma. Conclusion: 8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative. © 2011 Bennett et al; licensee BioMed Central Ltd.

引用

共 8 条

[1]

Kemp A.M., Butler A., Morris S., Mann M., Kemp K.W., Rolfe K., Sibert J.R., Maguire S., Which radiological investigations should be performed to identify fractures in suspected child abuse?, Clinical Radiology, 61, 9, pp. 723-736, (2006)

[2]

Sane S.M., American Academy of Pediatrics, Section on Radiology: Diagnostic Imaging of Child Abuse, Pediatrics, 105, pp. 1345-1348, (2000)

[3]

Di Pietro M.A., Aaopso R., Diagnostic Imaging of Child Abuse, Pediatrics, 123, pp. 1430-1435, (2009)

[4]

Kleinman P.K., Nimkin K., Spevak M.R., Rayder S.M., Madansky D.L., Shelton Y.A., Patterson M.M., Follow-up skeletal surveys in suspected child abuse, American Journal of Roentgenology, 167, 4, pp. 893-896, (1996)

[5]

Kleinman P.K., Skeletal Imaging Strategies, Diagnostic Imaging of Child Abuse, pp. 237-241, (1998)

[6]

Zimmerman S., Makoroff K., Care M., Thomas A., Shapiro R., Utility of follow-up skeletal surveys in suspected child physical abuse evaluations, Child Abuse and Neglect, 29, 10, pp. 1075-1083, (2005)

[7]

Harlan S.R., Follow-up skeletal surveys for nonaccidental trauma: Can a more limited survey be performed, Pediatr Radiol, 39, pp. 962-968, (2009)

[8]

Applegate K.E., ACR practice guideline for skeletal surveys in children, American College of Radiology, pp. 203-207, (2006)

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