TY - JOUR PY - 2023// TI - International consensus statement on the radiological screening of contact children in the context of suspected child physical abuse JO - JAMA pediatrics A1 - Mankad, Kshitij A1 - Sidpra, Jai A1 - Mirsky, David M. A1 - Oates, Adam J. A1 - Colleran, Gabrielle C. A1 - Lucato, Leandro T. A1 - Kan, Elaine A1 - Kilborn, Tracy A1 - Agrawal, Nina A1 - Teeuw, Arianne H. A1 - Kelly, Patrick A1 - Zeitlin, Deborah A1 - Carter, Jamieson A1 - Debelle, Geoff D. A1 - Berger, Rachel P. A1 - Christian, Cindy W. A1 - Lindberg, Daniel M. A1 - Raissaki, Maria A1 - Argyropoulou, Maria A1 - Adamsbaum, Catherine A1 - Cain, Timothy A1 - van Rijn, Rick R. A1 - Silvera, V. Michelle A1 - Rossi, Andrea A1 - Kemp, Alison M. A1 - Choudhary, Arabinda K. A1 - Offiah, Amaka C. SP - ePub EP - ePub VL - ePub IS - ePub N2 - IMPORTANCE: Physical abuse is a common but preventable cause of long-term childhood morbidity and mortality. Despite the strong association between abuse in an index child and abuse in contact children, there is no guidance outlining how to screen the latter, significantly more vulnerable group, for abusive injuries. Consequently, the radiological assessment of contact children is often omitted, or variably performed, allowing occult injuries to go undetected and increasing the risk of further abuse.

OBJECTIVE: To report an evidence-based and consensus-derived set of best practices for the radiological screening of contact children in the context of suspected child physical abuse. EVIDENCE REVIEW: This consensus statement is supported by a systematic review of the literature and the clinical opinion of an internationally recognized group of 26 experts. The modified Delphi consensus process comprised 3 meetings of the International Consensus Group on Contact Screening in Suspected Child Physical Abuse held between February and June 2021.

FINDINGS: Contacts are defined as the asymptomatic siblings, cohabiting children, or children under the same care as an index child with suspected child physical abuse. All contact children should undergo a thorough physical examination and a history elicited prior to imaging. Contact children younger than 12 months should have neuroimaging, the preferred modality for which is magnetic resonance imaging, and skeletal survey. Contact children aged 12 to 24 months should undergo skeletal survey. No routine imaging is indicated in asymptomatic children older than 24 months. Follow-up skeletal survey with limited views should be performed if abnormal or equivocal at presentation. Contacts with positive findings should be investigated as an index child.

CONCLUSIONS AND RELEVANCE: This Special Communication reports consensus recommendations for the radiological screening of contact children in the context of suspected child physical abuse, establishing a recognized baseline for the stringent evaluation of these at-risk children and providing clinicians with a more resilient platform from which to advocate for them.

Language: en

LA - en SN - 2168-6211 UR - http://dx.doi.org/10.1001/jamapediatrics.2022.6184 ID - ref1 ER -