Radiology in suspected non-accidental injury: theory and practice in The Netherlands.
BACKGROUND
This study evaluates radiological imaging in suspected non accidental injury (NAI) in children below the age of 2 years in the Netherlands.


METHODS
The study consisted of two parts; first an on-line questionnaire on suspected NAI, amongst radiological practices within the Netherlands. The second part of the study was a retrospective analysis of skeletal surveys in children under the age of 2 years, which were reviewed in an expert centre of forensic medicine on request of the public prosecutor.


RESULTS
Out of 116 hospitals 45 (39%) radiologists completed the on-line questionnaire; 8 (8%) of the proposed skeletal surveys complied with the ACR criteria. A total of 29 skeletal surveys in 26 children were reviewed. The median age at the time of the radiographic exam was 3 months for both boys and girls. Only 2 (7%) studies complied with the ACR criteria.


CONCLUSIONS
The results of our study show that, in theory as well as in practice, Dutch radiological practices show a large variation in imaging protocols for suspected NAI.
van Rijn
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Department of Radiology, Academic Medical Centre/Emma Children's Hospital, Amsterdam, The Netherlands. r.r.vanrijn@amc.uva.nl
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D000059:Accidents; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011859:Radiography; D011871:Radiology / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires