@article{ref1,
title="Growth recovery lines: a specific indicator of child abuse and neglect?",
journal="Pediatric radiology",
year="2019",
author="Spiller, Lora R. and Kellogg, Nancy D. and Mercado-Deane, Maria-Gisela and Zarka, Anthony I. and Gelfond, Jonathan A. L.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Growth recovery lines are radiodense lines in long bones reported to be indicators of stress. <br><br>OBJECTIVE: The purpose of this study was to understand the distribution, quantity and associations of growth recovery lines in children ages 0-24 months with high and low risk for child maltreatment. <br><br>MATERIALS AND METHODS: We conducted a retrospective cohort study of children ages 0-24 months who had skeletal surveys and an assessment for maltreatment. Growth recovery lines, fractures and osteopenia were assessed independently by two pediatric radiologists blinded to the abuse likelihood. <br><br>RESULTS: Of the 135 children in this study, 58 were in the low-risk group, 26 were in the neglect group, and 51 were in the physical abuse group. Children in the neglected and physically abused groups had 1.73 times (95% confidence interval [CI] of 1.16, 2.59), P=0.007) and 1.84 times (95% CI 1.28, 2.63, P<0.001) more growth recovery lines than the low-risk group, respectively. Growth recovery lines occurred at an earlier age in the neglect group (age interaction P=0.03) and abuse group (age interaction P=0.01) compared to the low-risk group. The specificity for maltreatment in children with at least 10 growth recovery lines in the long bones was greater than 84%, while sensitivity was less than 35%. The most common locations for growth recovery lines were distal radius, proximal tibia and distal tibia. <br><br>CONCLUSION: In the absence of a known major stressor, physical abuse and neglect should be considered in children younger than 24 months with at least 10 growth recovery lines.<p /> <p>Language: en</p>",
language="en",
issn="0301-0449",
doi="10.1007/s00247-019-04526-x",
url="http://dx.doi.org/10.1007/s00247-019-04526-x"
}