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Nonaccidental Trauma
Bimal Vyas, MD, MS; Andrew T. Trout, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Nonaccidental trauma (NAT)
            • Synonyms

              • Nonaccidental injury (NAI)
            • Definitions

              • Abusive skeletal injuries are suspected in injury of nonambulatory child, incompatible injury and explanation, delay in seeking medical attention, multiple fractures, and fall as explained etiology for fracture
              • Child maltreatment is broad term encompassing abuse (physical, emotional, sexual) and neglect (physical, emotional, medical, educational, supervisional)
              • Physical abuse is inflicted injury to child

            IMAGING

            • General Features

              • Nuclear Medicine Findings

                • Imaging Recommendations

                  • Radiographic Findings

                    • CT Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Rao R et al: Radiation doses in diagnostic imaging for suspected physical abuse. Arch Dis Child. 104(9):863-8, 2019
                                        2. Nguyen A et al: Imaging of non-accidental injury; what is clinical best practice? J Med Radiat Sci. 65(2):123-30, 2018
                                        3. Raynor E et al: The detection of significant fractures in suspected infant abuse. J Forensic Leg Med. 60:9-14, 2018
                                        4. Bainbridge JK et al: Should bone scintigraphy be used as a routine adjunct to skeletal survey in the imaging of non-accidental injury? A 10 year review of reports in a single centre. Clin Radiol. 70(8):e83-9, 2015
                                        5. Jackson AM et al: Aspects of abuse: recognizing and responding to child maltreatment. Curr Probl Pediatr Adolesc Health Care. 45(3):58-70, 2015
                                        6. Sheybani EF et al: Pediatric nonaccidental abdominal trauma: what the radiologist should know. Radiographics. 34(1):139-53, 2014
                                        7. Kleinman PK et al: Yield of radiographic skeletal surveys for detection of hand, foot, and spine fractures in suspected child abuse. AJR Am J Roentgenol. 200(3):641-4, 2013
                                        8. van Rijn RR et al: Educational paper: imaging child abuse: the bare bones. Eur J Pediatr. 171(2):215-24, 2012
                                        9. Meyer JS et al: ACR Appropriateness Criteria on suspected physical abuse-child. J Am Coll Radiol. 8(2):87-94, 2011
                                        10. Drubach LA et al: Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology. 255(1):173-81, 2010
                                        11. Stauss J et al: Guidelines for paediatric bone scanning with 99mTc-labelled radiopharmaceuticals and 18F-fluoride. Eur J Nucl Med Mol Imaging. 37(8):1621-8, 2010
                                        12. Offiah A et al: Skeletal imaging of child abuse (non-accidental injury). Pediatr Radiol. 39(5):461-70, 2009
                                        13. Section on Radiology; American Academy of Pediatrics: Diagnostic imaging of child abuse. Pediatrics. 123(5):1430-5, 2009
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Nonaccidental trauma (NAT)
                                                  • Synonyms

                                                    • Nonaccidental injury (NAI)
                                                  • Definitions

                                                    • Abusive skeletal injuries are suspected in injury of nonambulatory child, incompatible injury and explanation, delay in seeking medical attention, multiple fractures, and fall as explained etiology for fracture
                                                    • Child maltreatment is broad term encompassing abuse (physical, emotional, sexual) and neglect (physical, emotional, medical, educational, supervisional)
                                                    • Physical abuse is inflicted injury to child

                                                  IMAGING

                                                  • General Features

                                                    • Nuclear Medicine Findings

                                                      • Imaging Recommendations

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Rao R et al: Radiation doses in diagnostic imaging for suspected physical abuse. Arch Dis Child. 104(9):863-8, 2019
                                                                              2. Nguyen A et al: Imaging of non-accidental injury; what is clinical best practice? J Med Radiat Sci. 65(2):123-30, 2018
                                                                              3. Raynor E et al: The detection of significant fractures in suspected infant abuse. J Forensic Leg Med. 60:9-14, 2018
                                                                              4. Bainbridge JK et al: Should bone scintigraphy be used as a routine adjunct to skeletal survey in the imaging of non-accidental injury? A 10 year review of reports in a single centre. Clin Radiol. 70(8):e83-9, 2015
                                                                              5. Jackson AM et al: Aspects of abuse: recognizing and responding to child maltreatment. Curr Probl Pediatr Adolesc Health Care. 45(3):58-70, 2015
                                                                              6. Sheybani EF et al: Pediatric nonaccidental abdominal trauma: what the radiologist should know. Radiographics. 34(1):139-53, 2014
                                                                              7. Kleinman PK et al: Yield of radiographic skeletal surveys for detection of hand, foot, and spine fractures in suspected child abuse. AJR Am J Roentgenol. 200(3):641-4, 2013
                                                                              8. van Rijn RR et al: Educational paper: imaging child abuse: the bare bones. Eur J Pediatr. 171(2):215-24, 2012
                                                                              9. Meyer JS et al: ACR Appropriateness Criteria on suspected physical abuse-child. J Am Coll Radiol. 8(2):87-94, 2011
                                                                              10. Drubach LA et al: Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology. 255(1):173-81, 2010
                                                                              11. Stauss J et al: Guidelines for paediatric bone scanning with 99mTc-labelled radiopharmaceuticals and 18F-fluoride. Eur J Nucl Med Mol Imaging. 37(8):1621-8, 2010
                                                                              12. Offiah A et al: Skeletal imaging of child abuse (non-accidental injury). Pediatr Radiol. 39(5):461-70, 2009
                                                                              13. Section on Radiology; American Academy of Pediatrics: Diagnostic imaging of child abuse. Pediatrics. 123(5):1430-5, 2009