title: Child abuse: practical application of autopsy, radiological, and microscopic studies.
abstract: A 17-month-old male infant died at home. The infant's right arm was immobilized because of a humeral fracture 1 month earlier. The circumstances of death appeared unclear to the police investigators and a medicolegal autopsy was carried out. External examination revealed diffuse ecchymoses of varying color. Postmortem imaging was performed prior to autopsy (X-rays, multislice computed tomography [MSCT], and focused brain magnetic resonance imaging [MRI]). These investigations revealed four rib fractures of varying ages, one of which was posterior. Cerebral and pericerebral traumatic lesions were also diagnosed: bilateral subdural hematomas, intraventricular, meningeal, and interpedoncular hemorrhages. In the abdomen, fresh blood was visible within the anterior abdominal wall and the mesenteric root. Autopsy and microscopic study confirmed these lesions. This case report illustrates the valuable assistance rendered by MSCT and MRI to diagnose abuse when a child has died in unclear circumstances.
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31403 Toulouse Cedex 4, France. fabded2@hotmail.com
authors.forename: Fabrice
authors.initials: F
authors.lastname: Dedouit
authors.forename: Céline
authors.initials: C
authors.lastname: Guilbeau-Frugier
authors.forename: Caroline
authors.initials: C
authors.lastname: Capuani
authors.forename: Annick
authors.initials: A
authors.lastname: Sévely
authors.forename: Francis
authors.initials: F
authors.lastname: Joffre
authors.forename: Daniel
authors.initials: D
authors.lastname: Rougé
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
authors.forename: Norbert
authors.initials: N
authors.lastname: Telmon