R. A. C. Bilo, S. G. F. Robben, R. R. van Rijn (eds): Forensic aspects of pediatric fractures: differentiating accidental trauma from child abuse (1st edn)

Excerpt

Any physician who has had the experience of testifying in a child abuse case, either for the prosecution or the defense, feels slightly naked in front of a judge or jury. That same feeling should occur to one early in the original patient encounter when one is asked how an injury could have come about. While it would be nice to pretend that because we have medical degrees and fellowships and certifications we can therefore know the truth about what we see, we must admit that we can only give probabilities and inferences. While we can identify pathology and translate the shadows of the patient into a diagnosis, the full truth might not be as simple as it appears. Most of the time there is a narrow range of possible diagnoses or etiologies. As in any modern scientific field, in order to be an authority on a subject we have to return to the journals and the books constantly and understand that yesterday’s truth, whether about the dating of fractures or the incidence of rib fractures in premature infants, is changed and refined by new investigation. We have been lucky to have Dr. Paul Kleinman’s 1998 seminal book “Diagnostic Imaging of Child Abuse.” It is among the most important books in any pediatric or radiology library. I am happy to say we now have some new authors who are building on this invaluable contribution. And the understanding of the truth moves on. …