Radiography after unexpected death in infants and children compared to autopsy.
BACKGROUND
Postmortem radiography may reveal skeletal and soft-tissue abnormalities of importance for the diagnosis of cause of death.


OBJECTIVE
To review the radiographs of children under 3 years of age who had died suddenly and unexpectedly. To compare the radiological and autopsy findings evaluating possible differences in children dying of SIDS and of an explainable cause.


METHODS
A total of 110 consecutive skeletal surveys performed between 1998 and 2002 were reviewed. All but one were performed before autopsy and comprised AP views of the appendicular and axial skeleton and thorax/abdomen, lateral views of the axial skeleton and thorax, and two oblique views of the ribs. Radiography and autopsy findings were compared.


RESULTS
Causes of death were classified as SIDS/borderline SIDS (n = 52) and non-SIDS (n = 58), with one case of abuse. In 102 infants there were 150 pathological findings, 88 involving the chest, 24 skeletal, and 38 miscellaneous findings. The radiological-pathological agreement was poor concerning pulmonary findings. Skeletal findings were sometimes important for the final diagnosis.


CONCLUSIONS
Radiography revealed many skeletal and soft-tissue findings. Pulmonary pathology was most frequently found, but showed poor agreement with autopsy findings. Recognizing skeletal findings related to abuse is important, as these may escape recognition at autopsy.
de Lange
Charlotte
C
Department of Paediatric Radiology, Rikshospitalet-Radiumhospitalet Medical Centre, Sognsvannsveien 20, 0027 Oslo, Norway. charlotte.eva.delange@rikshospitalet.no
Vege
Ashild
A
Stake
Gunnar
G
D001344:Autopsy / Q000706:statistics & numerical data*; D002423:Cause of Death; D002675:Child, Preschool; D003645:Death, Sudden / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009664:Norway / Q000453:epidemiology; D013398:Sudden Infant Death / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*