The role of the follow-up chest radiograph in suspected non-accidental injury.
BACKGROUND
Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection.


OBJECTIVE
To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury.


METHODS
The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend.


RESULTS
Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted.


CONCLUSIONS
The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children.
Anilkumar
Adikesavalu
A
Department of Radiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Derby Road, Nottingham NG7 2UH, UK.
Fender
Laura J
LJ
Broderick
Nigel J
NJ
Somers
John M
JM
Halliday
Katharine E
KE
D002649:Child Abuse; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013902:Radiography, Thoracic; D012253:Rib Fractures / Q000000981:diagnostic imaging*