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The Radiographic Approach to Child Abuse
BACKGROUND: Osseous injuries are a major facet of child abuse and in most patients radiographic imaging plays a major role in diagnosis. While some injuries are typically produced as a result of excessive and inappropriate force other injuries are nonspecific in terms of their causation, but become...
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Formato: | Texto |
Lenguaje: | English |
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Springer-Verlag
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032862/ https://www.ncbi.nlm.nih.gov/pubmed/20544318 http://dx.doi.org/10.1007/s11999-010-1414-5 |
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author | Dwek, Jerry R. |
author_facet | Dwek, Jerry R. |
author_sort | Dwek, Jerry R. |
collection | PubMed |
description | BACKGROUND: Osseous injuries are a major facet of child abuse and in most patients radiographic imaging plays a major role in diagnosis. While some injuries are typically produced as a result of excessive and inappropriate force other injuries are nonspecific in terms of their causation, but become suspicious when the history provided by the caretakers is inconsistent with the type of injury produced. QUESTIONS/PURPOSES: I detail the radiographic imaging of the more characteristic of the highly specific injuries, discuss the major issues that relate to some moderate- or low-specificity injuries, and describe several diseases that mimic abuse. METHODS: A review of the current and recent literature focused on the radiographic imaging of child abuse was performed by searching the National Library of Medicine database at pubmed.gov. Keywords used included: radiology, fracture, child abuse, and/or nonaccidental trauma. RESULTS: Injuries that are highly specific for the diagnosis of abuse include metaphyseal corner fractures, posteromedial rib fractures, and sternal, scapular, and spinous process fractures. Lesions of moderate specificity include, among other injuries, multiple fractures of various ages and epiphyseal separations. Long-bone fractures and clavicular fractures, while common, are of low specificity. In addition to the appropriate accurate diagnosis of these injuries, several diseases and syndromes may mimic abuse due to the similarity in the radiographic picture. CONCLUSIONS: Stratification of fractures sustained in child abuse according to specificity and an understanding of the several diseases that mimic abuse are helpful in the accurate diagnosis of child abuse. LEVEL OF EVIDENCE: Level V, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence. |
format | Text |
id | pubmed-3032862 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-30328622011-03-16 The Radiographic Approach to Child Abuse Dwek, Jerry R. Clin Orthop Relat Res Symposium: Nonaccidental Trauma in Children BACKGROUND: Osseous injuries are a major facet of child abuse and in most patients radiographic imaging plays a major role in diagnosis. While some injuries are typically produced as a result of excessive and inappropriate force other injuries are nonspecific in terms of their causation, but become suspicious when the history provided by the caretakers is inconsistent with the type of injury produced. QUESTIONS/PURPOSES: I detail the radiographic imaging of the more characteristic of the highly specific injuries, discuss the major issues that relate to some moderate- or low-specificity injuries, and describe several diseases that mimic abuse. METHODS: A review of the current and recent literature focused on the radiographic imaging of child abuse was performed by searching the National Library of Medicine database at pubmed.gov. Keywords used included: radiology, fracture, child abuse, and/or nonaccidental trauma. RESULTS: Injuries that are highly specific for the diagnosis of abuse include metaphyseal corner fractures, posteromedial rib fractures, and sternal, scapular, and spinous process fractures. Lesions of moderate specificity include, among other injuries, multiple fractures of various ages and epiphyseal separations. Long-bone fractures and clavicular fractures, while common, are of low specificity. In addition to the appropriate accurate diagnosis of these injuries, several diseases and syndromes may mimic abuse due to the similarity in the radiographic picture. CONCLUSIONS: Stratification of fractures sustained in child abuse according to specificity and an understanding of the several diseases that mimic abuse are helpful in the accurate diagnosis of child abuse. LEVEL OF EVIDENCE: Level V, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence. Springer-Verlag 2010-06-11 2011-03 /pmc/articles/PMC3032862/ /pubmed/20544318 http://dx.doi.org/10.1007/s11999-010-1414-5 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Symposium: Nonaccidental Trauma in Children Dwek, Jerry R. The Radiographic Approach to Child Abuse |
title | The Radiographic Approach to Child Abuse |
title_full | The Radiographic Approach to Child Abuse |
title_fullStr | The Radiographic Approach to Child Abuse |
title_full_unstemmed | The Radiographic Approach to Child Abuse |
title_short | The Radiographic Approach to Child Abuse |
title_sort | radiographic approach to child abuse |
topic | Symposium: Nonaccidental Trauma in Children |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032862/ https://www.ncbi.nlm.nih.gov/pubmed/20544318 http://dx.doi.org/10.1007/s11999-010-1414-5 |
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