[Accident or maltreatment? Radiographic X‑ray patterns in non‑accidental trauma : The concept of sentinel injuries].
The focus of this review article is on child abuse and the radiographic pattern of X‑ray findings. The radiologist should be able to recognize typical injuries resulting from child abuse. In some cases the findings are highly specific for abuse and these include metaphyseal corner fractures of the long bones in children aged up to 24 months. In other cases the fractures are not specific but highly indicative of child abuse: rib fractures, for example can be associated with child abuse in more than 50 % of the cases; however, maltreatment is difficult to diagnose without taking the entire pattern of skeletal findings into consideration so that a radiological screening of the entire skeleton is often necessary. The concept of sentinel injuries might be helpful for deciding in which cases a complete skeletal screening should be performed. In the age group up to 24 months old a complete skeletal status (with some exceptions) is recommended if one of the three sentinel injuries of rib fractures, intracranial bleeding and abdominal trauma is present.
Abteilung für Kinderradiologie, Uniklinikum Leipzig AöR, Liebigstr. 20a, 04103, Leipzig, Deutschland. fw.hirsch@medizin.uni-leipzig.de.
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Hirsch
Abteilung für Kinderradiologie, Uniklinikum Leipzig AöR, Liebigstr. 20a, 04103, Leipzig, Deutschland.
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Sorge
Abteilung für Kinderradiologie, Uniklinikum Leipzig AöR, Liebigstr. 20a, 04103, Leipzig, Deutschland.
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Roth
Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Leipzig, Uniklinikum Leipzig AöR, Liebigstraße 20a, 04103, Leipzig, Deutschland.
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Gosemann
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000059:Accidents / Q000145:classification; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000941:ethics / Q000331:legislation & jurisprudence; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging*; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011859:Radiography / Q000379:methods*; D012253:Rib Fractures / Q000000981:diagnostic imaging*
Child abuse; Diagnostic X‑ray radiology; Interdisciplinary treatment; Skeletal status; Synopsis of findings