Andrew Sonin, MD, FACR; Kirkland W. Davis, MD, FACR
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
Nonaccidental trauma
Trauma X
Battered child syndrome
Shaken baby syndrome
Definitions
Skeletal injury to child due to violent act of another individual
Other organ injuries often seen as well
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Barber I et al: The yield of high-detail radiographic skeletal surveys in suspected infant abuse. Pediatr Radiol. 45(1):69-80, 2015
Deutsch SA: A struggle for certainty--protecting the vulnerable. N Engl J Med. 372(6):506-7, 2015
Phillips KL et al: Radiographic skeletal survey for non-accidental injury: Systematic review and development of a national New Zealand protocol. J Med Imaging Radiat Oncol. 59(1):54-65, 2015
Flaherty EG et al: Evaluating children with fractures for child physical abuse. Pediatrics. 133(2):e477-89, 2014
Shelmerdine SC et al: Who are we missing? Too few skeletal surveys for children with humeral and femoral fractures. Clin Radiol. 69(12):e512-6, 2014
Meyer JS et al: ACR Appropriateness Criteria(®) on suspected physical abuse-child. J Am Coll Radiol. 8(2):87-94, 2011
Ravichandiran N et al: Delayed identification of pediatric abuse-related fractures. Pediatrics. 125(1):60-6, 2010
Hansoti B et al: Limb fractures and nonaccidental injury in children less than 24 months of age. Eur J Emerg Med. 15(2):63-6, 2008
Peters ML et al: The presence of bruising associated with fractures. Arch Pediatr Adolesc Med. 162(9):877-81, 2008
Coffey C et al: The risk of child abuse in infants and toddlers with lower extremity injuries. J Pediatr Surg. 40(1):120-3, 2005
Grayev AM et al: Metaphyseal fractures mimicking abuse during treatment for clubfoot. Pediatr Radiol. 31(8):559-63, 2001
Nimkin K et al: Fractures of the hands and feet in child abuse: imaging and pathologic features. Radiology. 203(1):233-6, 1997
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the proximal humerus. AJR Am J Roentgenol. 167(6):1399-403, 1996
dos Santos LM et al: Soft tissue swelling with fractures: abuse versus nonintentional. Pediatr Emerg Care. 11(4):215-6, 1995
Conway JJ et al: The role of bone scintigraphy in detecting child abuse. Semin Nucl Med. 23(4):321-33, 1993
Stewart G et al: Trauma in infants less than three months of age. Pediatr Emerg Care. 9(4):199-201, 1993
Oestreich AE et al: The periphysis and its effect on the metaphysis: I. Definition and normal radiographic pattern. Skeletal Radiol. 21(5):283-6, 1992
McClelland CQ et al: Fractures in the first year of life. A diagnostic dilemma. Am J Dis Child. 136(1):26-9, 1982
Skeletal injury to child due to violent act of another individual
Other organ injuries often seen as well
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Barber I et al: The yield of high-detail radiographic skeletal surveys in suspected infant abuse. Pediatr Radiol. 45(1):69-80, 2015
Deutsch SA: A struggle for certainty--protecting the vulnerable. N Engl J Med. 372(6):506-7, 2015
Phillips KL et al: Radiographic skeletal survey for non-accidental injury: Systematic review and development of a national New Zealand protocol. J Med Imaging Radiat Oncol. 59(1):54-65, 2015
Flaherty EG et al: Evaluating children with fractures for child physical abuse. Pediatrics. 133(2):e477-89, 2014
Shelmerdine SC et al: Who are we missing? Too few skeletal surveys for children with humeral and femoral fractures. Clin Radiol. 69(12):e512-6, 2014
Meyer JS et al: ACR Appropriateness Criteria(®) on suspected physical abuse-child. J Am Coll Radiol. 8(2):87-94, 2011
Ravichandiran N et al: Delayed identification of pediatric abuse-related fractures. Pediatrics. 125(1):60-6, 2010
Hansoti B et al: Limb fractures and nonaccidental injury in children less than 24 months of age. Eur J Emerg Med. 15(2):63-6, 2008
Peters ML et al: The presence of bruising associated with fractures. Arch Pediatr Adolesc Med. 162(9):877-81, 2008
Coffey C et al: The risk of child abuse in infants and toddlers with lower extremity injuries. J Pediatr Surg. 40(1):120-3, 2005
Grayev AM et al: Metaphyseal fractures mimicking abuse during treatment for clubfoot. Pediatr Radiol. 31(8):559-63, 2001
Nimkin K et al: Fractures of the hands and feet in child abuse: imaging and pathologic features. Radiology. 203(1):233-6, 1997
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the proximal humerus. AJR Am J Roentgenol. 167(6):1399-403, 1996
dos Santos LM et al: Soft tissue swelling with fractures: abuse versus nonintentional. Pediatr Emerg Care. 11(4):215-6, 1995
Conway JJ et al: The role of bone scintigraphy in detecting child abuse. Semin Nucl Med. 23(4):321-33, 1993
Stewart G et al: Trauma in infants less than three months of age. Pediatr Emerg Care. 9(4):199-201, 1993
Oestreich AE et al: The periphysis and its effect on the metaphysis: I. Definition and normal radiographic pattern. Skeletal Radiol. 21(5):283-6, 1992
McClelland CQ et al: Fractures in the first year of life. A diagnostic dilemma. Am J Dis Child. 136(1):26-9, 1982