title: Skeletal and radiological manifestations of child abuse: Implications for study in past populations.
abstract: Child abuse in its various types such as physical, emotional, sexual, and neglect has been document throughout history. However, before the mid-20th century, inflicted injuries to children was overlooked in part because children were often viewed as property. According to the World Health Organization, 57,000 children were the victims of homicide in the year 2000. In this paper we present the skeletal and radiological manifestation of physical abuse and fatal neglect and provide recommendations to assess child maltreatment from past populations. Pediatric biomechanical factors and healing are discussed as it is important to keep in mind that children are not just small adults. Skeletal and radiological indicators of nonaccidental or inflicted injuries are reviewed from the literature. Inflicted injuries are presented based on specificity to identify child abuse. In addition, skeletal indicators that could help assess fatal starvation are also reviewed and metabolic diseases are proposed as potential evidence of neglect. A recent child homicide is presented and used to illustrate the difficulty in assessing child maltreatment. Present-day clinical child abuse protocols are used to provide recommendations to assess child abuse in a bioarchaeological context. Clin. Anat. 29:844-853, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Sociology and Anthropology, North Carolina State University, Raleigh, North Carolina. ahross@ncsu.edu.
authors.forename: Ann H
authors.initials: AH
authors.lastname: Ross
authors.affiliation: Department of Sociology and Anthropology, North Carolina State University, Raleigh, North Carolina.
authors.forename: Chelsey A
authors.initials: CA
authors.lastname: Juarez
mesh_terms: D001497:Battered Child Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D016723:Bone Remodeling; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology*; D002649:Child Abuse / Q000175:diagnosis*; D017809:Fatal Outcome; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D013217:Starvation / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: child abuse; disease mimicry; fatal neglect; physical abuse; skeletal indicators