Non-accidental trauma: the role of radiology.
Non-accidental trauma is a significant source of morbidity and mortality in the pediatric population. Given the vulnerable state of the child, the radiologist can often provide valuable diagnostic information in the setting of suspected abuse. This review focuses on common findings of abusive trauma and serves as a guide to aid in clinical decision-making for providers of emergency medicine and pediatrics. Amid this discussion is an assessment of modern controversies regarding reported mimicking pathologies, recapitulation of the current state of evidence with respect to radiologic findings of abuse, and examination of the contribution that spine imaging may add to the diagnosis of possible abusive head trauma in the acutely injured child. Recommendations for avoiding pitfalls regarding the dating of intracranial injuries are discussed, and illustrated depictions of perpetrator-induced pathology are provided to aid in the understanding of these injuries. Through the use of the appropriate approach to imaging and evidence-based guidelines regarding radiologic findings, the role of radiology is to provide fundamental clues to diagnose and prevent recurrence of abusive injury in patients who cannot speak for themselves.
Department of Diagnostic Radiology and Children's Health Children's Medical Center Dallas, University of Texas Southwestern Medical Center, 1935 Medical District Dr, Dallas, TX, 75235, USA. cpfeifer@phoenixchildrens.com.|Department of Medical Imaging, Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ, 85016, USA. cpfeifer@phoenixchildrens.com.
Cory M
CM
Pfeifer
Department of Diagnostic Radiology and Children's Health Children's Medical Center Dallas, University of Texas Southwestern Medical Center, 1935 Medical District Dr, Dallas, TX, 75235, USA.
Matthew R
MR
Hammer
Department of Diagnostic Radiology and Children's Health Children's Medical Center Dallas, University of Texas Southwestern Medical Center, 1935 Medical District Dr, Dallas, TX, 75235, USA.
Kate L
KL
Mangona
Department of Diagnostic Radiology and Children's Health Children's Medical Center Dallas, University of Texas Southwestern Medical Center, 1935 Medical District Dr, Dallas, TX, 75235, USA.
Timothy N
TN
Booth
D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D003657:Decision Making; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans
Abusive head trauma; Child abuse; Classic metaphyseal lesion; Non-accidental injury; Non-accidental trauma