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Pediatric Radiology

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30.03.2021 | Child abuse imaging

Fractures of child abuse

verfasst von: Megan B. Marine, Monica M. Forbes-Amrhein

Erschienen in: Pediatric Radiology | Ausgabe 6/2021

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Abstract

The objective of this paper is to review common challenges when evaluating fractures in the setting of possible child abuse and approaches to navigate them. This paper reviews the variety of imaging modalities available for evaluating child abuse and the advantages/disadvantages of each. Additionally, the authors discuss management of equivocal fractures, including the impact of double-reading skeletal surveys. The complexity of dating the acuity of fractures in young children is discussed. Utilizing the knowledge of fracture type, fracture patterns and patient history, as well as in the setting of cardiopulmonary resuscitation, the authors provide methods for determining the likelihood of abuse.

Wood JN, Fakeye O, Feudtner C et al (2014) Development of guidelines for skeletal survey in young children with fractures. Pediatrics 134:45–53PubMedPubMedCentralCrossRef

Wood JN, Fakeye O, Mondestin V et al (2015) Development of hospital-based guidelines for skeletal survey in young children with bruises. Pediatrics 135:e312–e320PubMedPubMedCentralCrossRef

Leventhal JM, Martin KD, Asnes AG (2008) Incidence of fractures attributable to abuse in young hospitalized children: results from analysis of a U.S. database. Pediatrics 122:599–604PubMedCrossRef

Wootton-Gorges SL, Soares BP, Alazraki AL et al (2017) ACR appropriateness criteria: suspected physical child abuse. J Am Coll Radiol 14:S338–S349PubMedCrossRef

Karmazyn B, Duhn RD, Jennings SG et al (2012) Long bone fracture detection in suspected child abuse: contribution of lateral views. Pediatr Radiol 42:463–469PubMedCrossRef

Don S (2004) Radiosensitivity of children: potential for overexposure in CR and DR and magnitude of doses in ordinary radiographic examinations. Pediatr Radiol 34:167–172CrossRef

Harlan SR, Nixon GW, Campbell KA et al (2009) Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed? Pediatr Radiol 39:962–968PubMedCrossRef

Harper NS, Eddleman S, Lindberg DM (2013) The utility of follow-up skeletal surveys in child abuse. Pediatrics 131:e672–e678PubMedCrossRef

Zimmerman S, Makoroff K, Care M et al (2005) Utility of follow-up skeletal surveys in suspected child physical abuse evaluations. Child Abuse Negl 29:1075–1083PubMedCrossRef

10.

Kleinman PK, Nimkin K, Spevak MR et al (1996) Follow-up skeletal surveys in suspected child abuse. AJR Am J Roentgenol 167:893–896PubMedCrossRef

11.

Karmazyn B, Marine MB, Wanner MR et al (2020) Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions. Pediatr Radiol 50:715–725PubMedCrossRef

12.

Bainbridge JK, Huey BM, Harrison SK (2015) Should bone scintigraphy be used as a routine adjunct to skeletal survey in the imaging of non-accidental injury? A 10 year review of reports in a single centre. Clin Radiol 70:e83–e89PubMedCrossRef

13.

Drubach LA, Johnston PR, Newton AW et al (2010) Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology 255:173–181PubMedCrossRef

14.

Conway JJ, Collins M, Tanz RR et al (1993) The role of bone scintigraphy in detecting child abuse. Semin Nucl Med 23:321–333PubMedCrossRef

15.

Coccaro G, Khedkar NY, Peller PJ, Martinez CJ (1994) An early false-negative bone scan in a spiral fracture. Clin Nucl Med 19:818–819PubMedCrossRef

16.

Kemp AM, Butler A, Morris S et al (2006) Which radiological investigations should be performed to identify fractures in suspected child abuse? Clin Radiol 61:723–736PubMedCrossRef

17.

Rao R, Browne D, Lunt B et al (2019) Radiation doses in diagnostic imaging for suspected physical abuse. Arch Dis Child 104:863–868PubMedCrossRef

18.

Sanchez TR, Grasparil AD, Chaudhari R et al (2018) Characteristics of rib fractures in child abuse — the role of low-dose chest computed tomography. Pediatr Emerg Care 34:81–83PubMedCrossRef

19.

Sanchez TR, Lee JS, Coulter KP et al (2015) CT of the chest in suspected child abuse using submillisievert radiation dose. Pediatr Radiol 45:1072–1076PubMedCrossRef

20.

Wootton-Gorges SL, Stein-Wexler R, Walton JW et al (2008) Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants. Child Abuse Negl 32:659–663PubMedCrossRef

21.

Perez-Rossello JM, Connolly SA, Newton AW et al (2010) Whole-body MRI in suspected infant abuse. AJR Am J Roentgenol 195:744–750PubMedCrossRef

22.

Nimkin K, Kleinman PK, Teeger S, Spevak MR (1995) Distal humeral physeal injuries in child abuse: MR imaging and ultrasonography findings. Pediatr Radiol 25:562–565PubMedCrossRef

23.

Supakul N, Hicks RA, Caltoum CB, Karmazyn B (2015) Distal humeral epiphyseal separation in young children: an often-missed fracture — radiographic signs and ultrasound confirmatory diagnosis. AJR Am J Roentgenol 204:W192–W198PubMedCrossRef

24.

Marine MB, Hibbard RA, Jennings SG, Karmazyn B (2019) Ultrasound findings in classic metaphyseal lesions: emphasis on the metaphyseal bone collar and zone of provisional calcification. Pediatr Radiol 49:913–921PubMedCrossRef

25.

Griffith JF, Rainer TH, Ching ASC et al (1999) Sonography compared with radiography in revealing acute rib fracture. AJR Am J Roentgenol 173:1603–1609PubMedCrossRef

26.

Kara M, Dikmen E, Erdal HH et al (2003) Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma. Eur J Cardiothorac Surg 24:608–613PubMedCrossRef

27.

Kelloff J, Hulett R, Spivey M (2009) Acute rib fracture diagnosis in an infant by US: a matter of child protection. Pediatr Radiol 39:70–72PubMedCrossRef

28.

Geijer H, Geijer M (2018) Added value of double reading in diagnostic radiology, a systematic review. Insights Imaging 9:287–301PubMedPubMedCentralCrossRef

29.

Eakins C, Ellis WD, Pruthi S et al (2012) Second opinion interpretations by specialty radiologists at a pediatric hospital: rate of disagreement and clinical implications. AJR Am J Roentgenol 199:916–920PubMedCrossRef

30.

Karmazyn B, Miller EM, Lay SE et al (2017) Double-read of skeletal surveys in suspected non-accidental trauma: what we learned. Pediatr Radiol 47:584PubMedCrossRef

31.

Karmazyn B, Wanner MR, Marine MB et al (2019) The added value of a second read by pediatric radiologists for outside skeletal surveys. Pediatr Radiol 49:203–209PubMedCrossRef

32.

Dwek JR (2011) The radiographic approach to child abuse. Clin Orthop Relat Res 469:776–789PubMedCrossRef

33.

Merten DF, Carpenter BL (1990) Radiologic imaging of inflicted injury in the child abuse syndrome. Pediatr Clin N Am 37:815–837CrossRef

34.

Servaes S, Brown SD, Choudhary AK et al (2016) The etiology and significance of fractures in infants and young children: a critical multidisciplinary review. Pediatr Radiol 46:591–600PubMedCrossRef

35.

Loder RT, Feinberg JR (2008) Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids’ inpatient database. J Pediatr Orthop 28:699

36.

Hui C, Joughin E, Goldstein S et al (2008) Femoral fractures in children younger than three years: the role of nonaccidental injury. J Pediatr Orthop 28:297–302PubMedCrossRef

37.

Kemp AM, Dunstan F, Harrison S et al (2008) Patterns of skeletal fractures in child abuse: systematic review. BMJ 337:a1518PubMedPubMedCentralCrossRef

38.

Lonergan GJ, Baker AM, Morey MK, Boos SC (2003) From the archives of the AFIP. Child abuse: radiologic–pathologic correlation. Radiographics 23:811–845PubMedCrossRef

39.

Kleinman PK, Marks SC Jr, Nimkin K et al (1996) Rib fractures in 31 abused infants: postmortem radiologic-histopathologic study. Radiology 200:807–810PubMedCrossRef

40.

Ng CS, Hall CM (1998) Costochondral junction fractures and intra-abdominal trauma in non-accidental injury (child abuse). Pediatr Radiol 28:671–676PubMedCrossRef

41.

Weber MA, Risdon RA, Offiah AC (2009) Rib fractures identified at post-mortem examination in sudden unexpected deaths in infancy (SUDI). Forensic Sci Int 189:75–81PubMedCrossRef

42.

Kleinman PK, Marks SC Jr, Richmond JM et al (1995) Inflicted skeletal injury: a postmortem radiologic–histopathologic study in 31 infants. AJR Am J Roentgenol 165:647–650PubMedCrossRef

43.

Kleinman PK, Perez-Rossello JM, Newton AW et al (2011) Prevalence of the classic metaphyseal lesion in infants at low versus high risk for abuse. AJR Am J Roentgenol 197:1005–1008PubMedCrossRef

44.

Tsai A, Coats B, Kleinman PK (2017) Biomechanics of the classic metaphyseal lesion: finite element analysis. Pediatr Radiol 47:1622–1630PubMedCrossRef

45.

Prosser I, Lawson Z, Evans A et al (2012) A timetable for the radiologic features of fracture healing in young children. AJR Am J Roentgenol 198:1014–1020PubMedCrossRef

46.

Islam O, Soboleski D, Symons S et al (2000) Development and duration of radiographic signs of bone healing in children. AJR Am J Roentgenol 175:75–78PubMedCrossRef

47.

Fadell M, Miller A, Trefan L et al (2017) Radiological features of healing in newborn clavicular fractures. Eur Radiol 27:2180–2187PubMedCrossRef

48.

Halliday KE, Broderick NJ, Somers JM et al (2011) Dating fractures in infants. Clin Radiol 66:1049–1054PubMedCrossRef

49.

Kleinman PK (2008) Problems in the diagnosis of metaphyseal fractures. Pediatr Radiol 38:S388–S394PubMedCrossRef

50.

Tsai A, Connolly SA, Ecklund K et al (2019) Subperiosteal new bone formation with the distal tibial classic metaphyseal lesion: prevalence on radiographic skeletal surveys. Pediatr Radiol 49:551–558PubMedCrossRef

51.

American Heart Association (2006) 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics 117:e989–e1004CrossRef

52.

Reyes JA, Somers GR, Taylor GP, Chiasson DA (2011) Increased incidence of CPR-related rib fractures in infants — is it related to changes in CPR technique? Resuscitation 82:545–548PubMedCrossRef

53.

Franke I, Pingen A, Schiffmann H et al (2014) Cardiopulmonary resuscitation (CPR)-related posterior rib fractures in neonates and infants following recommended changes in CPR techniques. Child Abuse Negl 38:1267–1274PubMedCrossRef

Titel: Fractures of child abuse
verfasst von: Megan B. Marine
Monica M. Forbes-Amrhein
Publikationsdatum: 30.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Radiology / Ausgabe 6/2021
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-020-04945-1

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