Interpreting fractures in child maltreatment |
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| Affiliation: | 1. Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK;2. UCL Great Ormond Street Institute of Child Health, London, UK;3. NIHR Great Ormond Street Hospital Biomedical Research Centre, UK;1. Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL;2. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL;3. Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, CA;4. Rady Children''s Hospital San Diego, San Diego, CA;5. Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY;6. Department of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH;1. University Children''s Hospital (Department of Pediatric Neurology and Developmental Medicine), Tübingen, Germany;2. Pediatric Neurology and Neurorehabilitation Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland;3. Department of Neuroradiology, University Hospital Tübingen, Germany;1. Children''s Protection Program, Seattle Children''s Hospital, and Department of Pediatrics, General Pediatric Division, University of Washington School of Medicine Seattle, WA 98105, USA |
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| Abstract: | ![]()
All paediatricians and health professionals working with young children need to be aware of the potential for child abuse to be a cause of physical injuries, such as fractures. Clinical experience, Serious Case Reviews and research show us that maltreatment should be kept in mind, in order for investigations to be carried out where appropriate and to prevent further harm. Whilst accidental fractures are common, fractures may also be the sentinel injury that alerts professionals to the possibility of child abuse, presenting clinically or detected as an occult injury on imaging for other reasons or when investigating a case of suspected maltreatment. The health professional evaluating a child with any fracture should be aware of features that raise the suspicion of abuse as a cause and be familiar with current recommendations for further investigations. This article outlines the current research concerning abusive fractures in children. It offers guidance on how to optimize radiological investigations and avoid common pitfalls in clinical practice. |
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| Keywords: | child abuse diagnosis fracture non-accidental injury skeletal survey |
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