@article{ref1,
title="The yield of high-detail radiographic skeletal surveys in suspected infant abuse",
journal="Pediatric radiology",
year="2014",
author="Barber, Ignasi and Perez-Rossello, Jeannette M. and Wilson, Celeste R. and Kleinman, Paul K.",
volume="45",
number="1",
pages="69-80",
abstract="BACKGROUND: Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. <br><br>OBJECTIVE: To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. MATERIAL AND METHODS: We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. <br><br>RESULTS: In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). <br><br>CONCLUSION: Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population.<p /> <p>Language: en</p>",
language="en",
issn="0301-0449",
doi="10.1007/s00247-014-3064-3",
url="http://dx.doi.org/10.1007/s00247-014-3064-3"
}