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Pediatric 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

            • Definitions

              • Pediatric nonaccidental trauma
                • Nonaccidental skeletal injuries 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
                • Diagnosis of child abuse can never be based solely on imaging and requires combination of clinical, investigative, and social findings

            IMAGING

            • General Features

              • F-18 NaF PET Bone Scan Findings

                • Imaging Recommendations

                  • Radiographic Findings

                    • CT Findings

                      DIFFERENTIAL DIAGNOSIS

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    • Reporting Tips

                                      Selected References

                                      1. Expert Panel on Pediatric Imaging:. et al: ACR Appropriateness Criteria® Suspected Physical Abuse-Child. J Am Coll Radiol. 14(5S):S338-S349, 2017
                                      2. Jackson AM et al: Aspects of abuse: recognizing and responding to child maltreatment. Curr Probl Pediatr Adolesc Health Care. 45(3):58-70, 2015
                                      3. Grant FD: ¹⁸F-fluoride PET and PET/CT in children and young adults. PET Clin. 9(3):287-97, 2014
                                      4. Sheybani EF et al: Pediatric nonaccidental abdominal trauma: what the radiologist should know. Radiographics. 34(1):139-53, 2014
                                      5. 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
                                      6. van Rijn RR et al: Educational paper: imaging child abuse: the bare bones. Eur J Pediatr. 171(2):215-24, 2012
                                      7. Meyer JS et al: ACR Appropriateness Criteria on suspected physical abuse-child. J Am Coll Radiol. 8(2):87-94, 2011
                                      8. Drubach LA et al: Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology. 255(1):173-81, 2010
                                      9. Offiah A et al: Skeletal imaging of child abuse (non-accidental injury). Pediatr Radiol. 39(5):461-70, 2009
                                      10. 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

                                                • Definitions

                                                  • Pediatric nonaccidental trauma
                                                    • Nonaccidental skeletal injuries 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
                                                    • Diagnosis of child abuse can never be based solely on imaging and requires combination of clinical, investigative, and social findings

                                                IMAGING

                                                • General Features

                                                  • F-18 NaF PET Bone Scan Findings

                                                    • Imaging Recommendations

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      • Image Interpretation Pearls

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Expert Panel on Pediatric Imaging:. et al: ACR Appropriateness Criteria® Suspected Physical Abuse-Child. J Am Coll Radiol. 14(5S):S338-S349, 2017
                                                                          2. Jackson AM et al: Aspects of abuse: recognizing and responding to child maltreatment. Curr Probl Pediatr Adolesc Health Care. 45(3):58-70, 2015
                                                                          3. Grant FD: ¹⁸F-fluoride PET and PET/CT in children and young adults. PET Clin. 9(3):287-97, 2014
                                                                          4. Sheybani EF et al: Pediatric nonaccidental abdominal trauma: what the radiologist should know. Radiographics. 34(1):139-53, 2014
                                                                          5. 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
                                                                          6. van Rijn RR et al: Educational paper: imaging child abuse: the bare bones. Eur J Pediatr. 171(2):215-24, 2012
                                                                          7. Meyer JS et al: ACR Appropriateness Criteria on suspected physical abuse-child. J Am Coll Radiol. 8(2):87-94, 2011
                                                                          8. Drubach LA et al: Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology. 255(1):173-81, 2010
                                                                          9. Offiah A et al: Skeletal imaging of child abuse (non-accidental injury). Pediatr Radiol. 39(5):461-70, 2009
                                                                          10. Section on Radiology; American Academy of Pediatrics: Diagnostic imaging of child abuse. Pediatrics. 123(5):1430-5, 2009