Citation

Sanchez TR, Grasparil AD, Chaudhari R, Coulter KP, Wootton-Gorges SL. Pediatr. Emerg. Care 2018; 34(2): 81-83.

Affiliation

From the *Division of Pediatric Radiology, University of California, Davis Medical Center Children's Hospital, Sacramento CA; †Cardinal Santos Medical Center, Philippines; ‡Department of Radiology, and §Department of Pediatrics, University of California, Davis Medical Center and Children's Hospital, Sacramento, CA.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0000000000000608

PMID

26760828

Abstract

OBJECTIVES: Our aim is to describe the radiologic characteristics of rib fractures in clinically diagnosed cases of child abuse and suggest a complementary imaging for radiographically occult injuries in highly suspicious cases of child abuse.

METHODS: Retrospective analysis of initial and follow-up skeletal surveys and computed tomography (CT) scans of 16 patients younger than 12 months were reviewed after obtaining approval from our institutional review board. The number, location, displacement, and age of the rib fractures were recorded.

RESULTS: Out of a total 105 rib fractures, 84% (87/105) were detected on the initial skeletal survey. Seventeen percent (18/105) were seen only after follow-up imaging, more than half of which (11/18) were detected on a subsequent CT. Majority of the fractures were posterior (43%) and anterior (30%) in location. An overwhelming majority (96%) of the fractures are nondisplaced.

CONCLUSIONS: Seventeen percent of rib fractures analyzed in the study were not documented on the initial skeletal survey. Majority of fractures are nondisplaced and located posteriorly or anteriorly, areas that are often difficult to assess especially in the acute stage. The CT scan is more sensitive in evaluating these types of fractures. Low-dose chest CT can be an important imaging modality for suspicious cases of child abuse when initial radiographic findings are inconclusive.

Language: en