Controversial aspects of imaging in child abuse: a second roundtable discussion from the ESPR child abuse taskforce.
Child abuse
Children
Fractures
Head
Infants
Magnetic resonance imaging
Physical abuse
Radiography
Spine
Journal
Pediatric radiology
ISSN: 1432-1998
Titre abrégé: Pediatr Radiol
Pays: Germany
ID NLM: 0365332
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
04
12
2022
accepted:
26
01
2023
revised:
24
01
2023
pubmed:
7
3
2023
medline:
23
3
2023
entrez:
6
3
2023
Statut:
ppublish
Résumé
This second roundtable discussion was convened at the 56th European Society of Paediatric Radiology (ESPR) 2022 Annual Meeting in Marseille, France, to discuss controversial aspects of imaging in child abuse. The following topics were discussed: Fracture dating-the published literature is broadly similar with respect to the identification of the radiographic stages of bony healing. The non-expert/general radiologist is encouraged to use broad descriptors of fracture healing (acute, healing or old) within their reports, rather than attempting to date fractures. The more experienced/expert radiologist, who may provide a timeframe/range to assist the courts, should be aware that any published timeframes are not absolute and that recent research indicates that the rate of healing may differ according to the bone affected and the age of the patient. Whole spine imaging in suspected abusive head trauma-this is recommended to enable a complete assessment of the neuraxis when abusive head trauma is suspected or diagnosed, particularly in the presence of intracranial and cervical subdural haemorrhage and cervical ligamentous injury. Cranial imaging in suspected physical abuse-both computed tomography (CT) and magnetic resonance imaging (MRI) remain complimentary depending on the clinical context in which they are used with CT remaining first-line in the assessment of children with (suspected abusive) head trauma prior to an early MRI. MRI is superior in its assessment of parenchymal injury and may be employed as first-line in age appropriate asymptomatic siblings of a child with suspected physical abuse.
Identifiants
pubmed: 36879046
doi: 10.1007/s00247-023-05618-5
pii: 10.1007/s00247-023-05618-5
pmc: PMC10027646
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
739-751Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023. The Author(s).
Références
Sethi D, Bellis M, Hughes K, et al. (2013) European report on preventing child maltreatment. WHO
Boal DK, Felman AH, Krugman RD (2001) Controversial aspects of child abuse: a roundtable discussion. 43rd annual meeting. Society for Pediatric Radiology Pediatr Radiol 31:760–774
pubmed: 11725746
doi: 10.1007/s002470100538
van Rijn RR, Sieswerda-Hoogendoorn T (2012) Educational paper: imaging child abuse: the bare bones. Eur J Pediatr 171:215–224
pubmed: 21626459
doi: 10.1007/s00431-011-1499-1
Karmazyn B, Lewis ME, Jennings SG et al (2011) The prevalence of uncommon fractures on skeletal surveys performed to evaluate for suspected abuse in 930 children: should practice guidelines change? AJR Am J Roentgenol 197:W159-163
pubmed: 21700979
doi: 10.2214/AJR.10.5733
Royal College of Paediatrics and Child Health (RCPCH) (2020) Child protection evidence systematic review on fractures. https://childprotection.rcpch.ac.uk/wp-content/uploads/sites/6/2020/10/Child-Protection-Evidence-Fractures-update-2020.pdf Accessed 19 October 2022
The Royal College of Radiologists & The Society and College of Radiographers (November 2018) The radiological investigation of suspected physical abuse in children. Revised first edition. London: The Royal College of Radiologists & The Society and College of Radiographers
Offiah AC, Adamsbaum C, van Rijn RR (2014) ESPR adopts British guidelines for imaging in suspected non-accidental injury as the European standard. Pediatr Radiol 44:1338
pubmed: 25287357
doi: 10.1007/s00247-014-3153-3
Wootton-Gorges SL, Soares BP, Alazraki AL et al (2017) ACR Appropriateness Criteria(®) Suspected Physical Abuse-Child. J Am Coll Radiol 14:S338-s349
pubmed: 28473090
doi: 10.1016/j.jacr.2017.01.036
Nguyen A, Hart R (2018) Imaging of non-accidental injury; what is clinical best practice? J Med Radiat Sci 65:123–130
pubmed: 29573327
pmcid: 5985993
doi: 10.1002/jmrs.269
Loder RT, Feinberg JR (2007) Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids’ inpatient database. J Pediatr Orthop 27:421–426
pubmed: 17513964
doi: 10.1097/01.bpb.0000271328.79481.07
Paddock M, Sprigg A, Offiah AC (2017) Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 1: initial considerations and appendicular skeleton. Clin Radiol 72:179–188
pubmed: 28063602
doi: 10.1016/j.crad.2016.11.016
Pickett TA (2015) The challenges of accurately estimating time of long bone injury in children. J Forensic Leg Med 33:105–110
pubmed: 26048508
doi: 10.1016/j.jflm.2015.04.012
O’Connor JF, Cohen J (1998) Dating fractures. In: Kleinman PK (ed) Diagnostic Imaging of Child Abuse, 2nd edn. Mosby, Boston, MA, pp 168–177
Cumming WA (1979) Neonatal skeletal fractures. Birth trauma or child abuse? J Can Assoc Radiol 30:30–33
pubmed: 429433
Yeo LI, Reed MH (1994) Staging of healing of femoral fractures in children. Can Assoc Radiol J 45:16–19
pubmed: 8118709
Islam O, Soboleski D, Symons S et al (2000) Development and duration of radiographic signs of bone healing in children. AJR Am J Roentgenol 175:75–78
pubmed: 10882250
doi: 10.2214/ajr.175.1.1750075
Offiah AC, Hall CM (2018) Radiological atlas of child abuse. Taylor & Francis
doi: 10.1201/9781315365466
Halliday KE, Broderick NJ, Somers JM, Hawkes R (2011) Dating fractures in infants. Clin Radiol 66:1049–1054
pubmed: 21763645
doi: 10.1016/j.crad.2011.06.001
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 198:1014–1020
pubmed: 22528890
doi: 10.2214/AJR.11.6734
Walters MM, Forbes PW, Buonomo C, Kleinman PK (2014) Healing patterns of clavicular birth injuries as a guide to fracture dating in cases of possible infant abuse. Pediatr Radiol 44:1224–1229
pubmed: 24777389
doi: 10.1007/s00247-014-2995-z
Warner C, Maguire S, Trefan L et al (2017) A study of radiological features of healing in long bone fractures among infants less than a year. Skeletal Radiol 46:333–341
pubmed: 28070625
doi: 10.1007/s00256-016-2563-8
Fadell M, Miller A, Trefan L et al (2017) Radiological features of healing in newborn clavicular fractures. Eur Radiol 27:2180–2187
pubmed: 27629420
doi: 10.1007/s00330-016-4569-y
Crompton S, Messina F, Klafkowski G et al (2021) Validating scoring systems for fracture healing in infants and young children: pilot study. Pediatr Radiol 51:1682–1689
pubmed: 33847785
pmcid: 8363550
doi: 10.1007/s00247-021-05038-3
Skellern CY, Wood DO, Murphy A, Crawford M (2000) Non-accidental fractures in infants: risk of further abuse. J Paediatr Child Health 36:590–592
pubmed: 11115038
doi: 10.1046/j.1440-1754.2000.00592.x
Hoskote AU, Martin K, Hormbrey P, Burns EC (2003) Fractures in infants: one in four is non-accidental. Child Abuse Rev 12:384–391
doi: 10.1002/car.806
Malone CA, Sauer NJ, Fenton TW (2011) A radiographic assessment of pediatric fracture healing and time since injury. J Forensic Sci 56:1123–1130
pubmed: 21644992
doi: 10.1111/j.1556-4029.2011.01820.x
Hufnagl KB (2005) An investigation of time since injury: a radiographic study of fracture healing. https://digitalcommons.lsu.edu/gradschool_theses/3032/ Accessed 22 November 2022
Paton DF (1992) Fractures and Orthopaedics. Churchill Livingstone, United Kingdom
Oates A, Halliday K, Offiah AC et al (2019) Shortage of paediatric radiologists acting as an expert witness: position statement from the British Society of Paediatric Radiology (BSPR) National Working Group on Imaging in Suspected Physical Abuse (SPA). Clin Radiol 74:496–502
pubmed: 31126587
doi: 10.1016/j.crad.2019.04.016
Haq I, Jayappa S, Desai SK et al (2021) Spinal ligamentous injury in abusive head trauma: a pictorial review. Pediatr Radiol 51:971–979
pubmed: 33999239
doi: 10.1007/s00247-020-04922-8
Maher CO (2017) Editorial. Screening for spine injury in abusive head trauma. J Neurosurg Pediatr 20:269–270
pubmed: 28665243
doi: 10.3171/2017.3.PEDS1775
Canty KW, Feldman KW, Bartnik-Olson B, et al. (2022) Current issues and controversies surrounding spine imaging and the significance of spinal subdural hemorrhage in suspected abusive head trauma. Pediatr Radiol
Kemp AM, Joshi AH, Mann M et al (2010) What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review. Arch Dis Child 95:355–360
pubmed: 19946011
doi: 10.1136/adc.2009.169110
Lynøe N, Eriksson A (2018) Consensus should be adapted to the evidence and not vice-versa. Acta Paediatr 107:1476
pubmed: 29385283
doi: 10.1111/apa.14247
Choudhary AK, Bradford RK, Dias MS et al (2012) Spinal subdural hemorrhage in abusive head trauma: a retrospective study. Radiology 262:216–223
pubmed: 22069156
doi: 10.1148/radiol.11102390
Choudhary AK, Ishak R, Zacharia TT, Dias MS (2014) Imaging of spinal injury in abusive head trauma: a retrospective study. Pediatr Radiol 44:1130–1140
pubmed: 24687620
doi: 10.1007/s00247-014-2959-3
Garcia-Pires F, Jayappa S, Desai S et al (2021) Spinal subdural hemorrhage in abusive head trauma: a pictorial review. Pediatr Radiol 51:980–990
pubmed: 33999240
doi: 10.1007/s00247-020-04931-7
Manish KK, Chandrakant SK, Abhay MN (2015) Spinal Subdural Haematoma. J Orthop Case Rep 5:72–74
Oh A, Sawvel M, Heaner D et al (2017) Changes in use of cervical spine magnetic resonance imaging for pediatric patients with nonaccidental trauma. J Neurosurg Pediatr 20:271–277
pubmed: 28665242
doi: 10.3171/2017.2.PEDS16644
Rabbitt AL, Kelly TG, Yan K et al (2020) Characteristics associated with spine injury on magnetic resonance imaging in children evaluated for abusive head trauma. Pediatr Radiol 50:83–97
pubmed: 31901991
pmcid: 7223732
doi: 10.1007/s00247-019-04517-y
Blangis F, Allali S, Cohen JF et al (2021) Variations in guidelines for diagnosis of child physical abuse in high-income countries: a systematic review. JAMA Netw Open 4:e2129068
pubmed: 34787659
pmcid: 8600386
doi: 10.1001/jamanetworkopen.2021.29068
Oates AJ, Sidpra J, Mankad K (2021) Parenchymal brain injuries in abusive head trauma. Pediatr Radiol 51:898–910
pubmed: 33638693
doi: 10.1007/s00247-021-04981-5
Idriz S, Patel JH, Ameli Renani S et al (2015) CT of normal developmental and variant anatomy of the pediatric skull: distinguishing trauma from normality. Radiographics 35:1585–1601
pubmed: 26207580
doi: 10.1148/rg.2015140177
Kemp AM, Dunstan F, Harrison S et al (2008) Patterns of skeletal fractures in child abuse: systematic review. BMJ 337:a1518
pubmed: 18832412
pmcid: 2563260
doi: 10.1136/bmj.a1518
Martin A, Paddock M, Johns CS et al (2020) Avoiding skull radiographs in infants with suspected inflicted injury who also undergo head CT: “a no-brainer?” Eur Radiol 30:1480–1487
pubmed: 31797078
doi: 10.1007/s00330-019-06579-w
Pennell C, Aundhia M, Malik A et al (2021) Utility of skull radiographs in infants undergoing 3D head CT during evaluation for physical abuse. J Pediatr Surg 56:1180–1184
pubmed: 33771371
doi: 10.1016/j.jpedsurg.2021.02.037
Cosgrave L, Bowie S, Walker C et al (2022) Abusive head trauma in children: radiographs of the skull do not provide additional information in the diagnosis of skull fracture when multiplanar computed tomography with three-dimensional reconstructions is available. Pediatr Radiol 52:924–931
pubmed: 35043263
doi: 10.1007/s00247-021-05256-9
Strauss KJ, Somasundaram E, Sengupta D et al (2019) Radiation dose for pediatric CT: comparison of pediatric versus adult imaging facilities. Radiology 291:158–167
pubmed: 30720404
doi: 10.1148/radiol.2019181753
Vázquez E, Delgado I, Sánchez-Montañez A et al (2014) Imaging abusive head trauma: why use both computed tomography and magnetic resonance imaging? Pediatr Radiol 44(Suppl 4):S589-603
pubmed: 25501731
doi: 10.1007/s00247-014-3216-5
Adamsbaum C, Rambaud C (2012) Abusive head trauma: don’t overlook bridging vein thrombosis. Pediatr Radiol 42:1298–1300
pubmed: 22885602
doi: 10.1007/s00247-012-2434-y
Karmazyn B, Reher TA, Supakul N et al (2022) Whole-spine MRI in children with suspected abusive head trauma. AJR Am J Roentgenol 218:1074–1087
pubmed: 35018794
doi: 10.2214/AJR.21.26674
Bhatia A, Mirsky DM, Mankad K et al (2021) Neuroimaging of retinal hemorrhage utilizing adjunct orbital susceptibility-weighted imaging. Pediatr Radiol 51:991–996
pubmed: 33710408
doi: 10.1007/s00247-020-04897-6
Thamburaj K, Soni A, Frasier LD et al (2019) Susceptibility-weighted imaging of retinal hemorrhages in abusive head trauma. Pediatr Radiol 49:210–216
pubmed: 30392163
doi: 10.1007/s00247-018-4292-8
Gencturk M, Cam I, Koksel Y, McKinney AM (2021) Role of susceptibility-weighted imaging in detecting retinal hemorrhages in children with head trauma. Clin Neuroradiol 31:611–617
pubmed: 32757073
doi: 10.1007/s00062-020-00939-6
Kralik SF, Supakul N, Wu IC et al (2019) Black bone MRI with 3D reconstruction for the detection of skull fractures in children with suspected abusive head trauma. Neuroradiology 61:81–87
pubmed: 30406272
doi: 10.1007/s00234-018-2127-9
Patel KB, Eldeniz C, Skolnick GB, et al. (2022) Cranial vault imaging for pediatric head trauma using a radial VIBE MRI sequence. J Neurosurg Pediatr:1–6
Bartoli M, Mannes I, Aikem N et al (2022) Is bridging vein rupture/thrombosis associated with subdural hematoma at birth? Pediatr Radiol 52:932–940
pubmed: 34988598
doi: 10.1007/s00247-021-05255-w
Adamsbaum C, Morel B, Ducot B et al (2014) Dating the abusive head trauma episode and perpetrator statements: key points for imaging. Pediatr Radiol 44(Suppl 4):S578-588
pubmed: 25501730
doi: 10.1007/s00247-014-3171-1
Mankad K, Sidpra J, Oates AJ et al (2021) Sibling screening in suspected abusive head trauma: a proposed guideline. Pediatr Radiol 51:872–875
pubmed: 33999232
pmcid: 8126595
doi: 10.1007/s00247-020-04917-5