Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed?
BACKGROUND
Studies have demonstrated the value of the follow-up skeletal survey in identifying additional fractures, clarifying indeterminate findings, and improving dating of skeletal injuries in victims of physical abuse.


OBJECTIVE
To determine whether a more limited follow-up survey could yield the same radiologic data as a full follow-up survey.


METHODS
The study cohort comprised 101 children who had follow-up surveys that met our inclusion criteria. Consensus readings of both original and follow-up surveys were performed by two pediatric radiologists. These results were compared to determine additional findings from the follow-up surveys. Limited skeletal survey protocols were evaluated to determine whether they would detect the same fractures seen with a complete osseous survey.


RESULTS
In the 101 children 244 fractures were identified on the initial osseous survey. Follow-up surveys demonstrated new information in 38 children (37.6%). A 15-view limited follow-up survey identified all additional information seen on the complete follow-up survey.


CONCLUSIONS
Our data demonstrate that a 15-view limited follow-up skeletal survey could be performed without missing clinically significant new fractures and still allow proper identification of confirmed fractures or normal findings. A limited survey would decrease radiation dose in children.
Harlan
Susan R
SR
Department of Radiology, University of Utah School of Medicine, Salt Lake City, UT, USA.
Nixon
G William
GW
Campbell
Kristine A
KA
Hansen
Karen
K
Prince
Jeffrey S
JS
D000059:Accidents / Q000706:statistics & numerical data; D002649:Child Abuse / Q000175:diagnosis* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011859:Radiography; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014589:Utah / Q000453:epidemiology