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Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children

Background: Timely diagnosis of child physical abuse is of paramount importance. The added value of bone scintigraphy (BS) after a negative radiological skeletal survey (RSS) in children with suspected physical abuse has never been evaluated. Objective: The objective of this study was to assess the...

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Autores principales: Blangis, Flora, Poullaouec, Cyrielle, Launay, Elise, Vabres, Nathalie, Sadones, Flavie, Eugène, Thomas, Cohen, Jérémie F., Chalumeau, Martin, Gras-Le Guen, Christèle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7545028/
https://www.ncbi.nlm.nih.gov/pubmed/33102400
http://dx.doi.org/10.3389/fped.2020.00498
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author Blangis, Flora
Poullaouec, Cyrielle
Launay, Elise
Vabres, Nathalie
Sadones, Flavie
Eugène, Thomas
Cohen, Jérémie F.
Chalumeau, Martin
Gras-Le Guen, Christèle
author_facet Blangis, Flora
Poullaouec, Cyrielle
Launay, Elise
Vabres, Nathalie
Sadones, Flavie
Eugène, Thomas
Cohen, Jérémie F.
Chalumeau, Martin
Gras-Le Guen, Christèle
author_sort Blangis, Flora
collection PubMed
description Background: Timely diagnosis of child physical abuse is of paramount importance. The added value of bone scintigraphy (BS) after a negative radiological skeletal survey (RSS) in children with suspected physical abuse has never been evaluated. Objective: The objective of this study was to assess the extent to which BS could improve the detection rate of skeletal injury in children with suspected physical abuse with an initial negative RSS. Methods: We used discharge codes to retrospectively identify children evaluated for suspected physical abuse in a university hospital (Nantes, France). We included all consecutive children younger than 3 years old who underwent both RSS and BS, with an interval of ≤96 h between tests, from 2013 to 2019. BS and RSS results were interpreted independently during the study period. We specifically analyzed BS results for children with a negative RSS to assess the value of BS as an add-on test. Results: Among the 268 children ≤3 years old with suspected physical abuse who underwent RSS, 140 (52%) also underwent BS within 96 h and were included in the analysis. The median age was 6 months old (interquartile range: 3–8). The detection rate of ≥1 skeletal injury with RSS alone was 49% (n = 69/140, 95% CI: 41–58%) vs. 58% (n = 81/140, 50–66%) with RSS followed by add-on BS, for an absolute increase in the detection rate of 9% points (95% CI: 4–14%). The number of children with a negative RSS who would need to undergo BS to detect one additional child with ≥1 skeletal injury was 6 (95% CI: 4–11). Conclusion: In young children with suspected physical abuse with a negative RSS, add-on BS would allow for a clinically significant improvement in the detection rate of skeletal injuries for a limited number of BS procedures required. Prospective multicenter studies are needed to confirm these findings.
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spelling pubmed-75450282020-10-22 Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children Blangis, Flora Poullaouec, Cyrielle Launay, Elise Vabres, Nathalie Sadones, Flavie Eugène, Thomas Cohen, Jérémie F. Chalumeau, Martin Gras-Le Guen, Christèle Front Pediatr Pediatrics Background: Timely diagnosis of child physical abuse is of paramount importance. The added value of bone scintigraphy (BS) after a negative radiological skeletal survey (RSS) in children with suspected physical abuse has never been evaluated. Objective: The objective of this study was to assess the extent to which BS could improve the detection rate of skeletal injury in children with suspected physical abuse with an initial negative RSS. Methods: We used discharge codes to retrospectively identify children evaluated for suspected physical abuse in a university hospital (Nantes, France). We included all consecutive children younger than 3 years old who underwent both RSS and BS, with an interval of ≤96 h between tests, from 2013 to 2019. BS and RSS results were interpreted independently during the study period. We specifically analyzed BS results for children with a negative RSS to assess the value of BS as an add-on test. Results: Among the 268 children ≤3 years old with suspected physical abuse who underwent RSS, 140 (52%) also underwent BS within 96 h and were included in the analysis. The median age was 6 months old (interquartile range: 3–8). The detection rate of ≥1 skeletal injury with RSS alone was 49% (n = 69/140, 95% CI: 41–58%) vs. 58% (n = 81/140, 50–66%) with RSS followed by add-on BS, for an absolute increase in the detection rate of 9% points (95% CI: 4–14%). The number of children with a negative RSS who would need to undergo BS to detect one additional child with ≥1 skeletal injury was 6 (95% CI: 4–11). Conclusion: In young children with suspected physical abuse with a negative RSS, add-on BS would allow for a clinically significant improvement in the detection rate of skeletal injuries for a limited number of BS procedures required. Prospective multicenter studies are needed to confirm these findings. Frontiers Media S.A. 2020-09-25 /pmc/articles/PMC7545028/ /pubmed/33102400 http://dx.doi.org/10.3389/fped.2020.00498 Text en Copyright © 2020 Blangis, Poullaouec, Launay, Vabres, Sadones, Eugène, Cohen, Chalumeau and Gras-Le Guen. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Blangis, Flora
Poullaouec, Cyrielle
Launay, Elise
Vabres, Nathalie
Sadones, Flavie
Eugène, Thomas
Cohen, Jérémie F.
Chalumeau, Martin
Gras-Le Guen, Christèle
Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children
title Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children
title_full Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children
title_fullStr Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children
title_full_unstemmed Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children
title_short Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children
title_sort bone scintigraphy after a negative radiological skeletal survey improves the detection rate of inflicted skeletal injury in children
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7545028/
https://www.ncbi.nlm.nih.gov/pubmed/33102400
http://dx.doi.org/10.3389/fped.2020.00498
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