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Paddock M, Choudhary AK, Jeanes A, Mankad K, Mannes I, Raissaki M, Adamsbaum C, Argyropoulou MI, van Rijn RR, Offiah AC. Controversial aspects of imaging in child abuse: a second roundtable discussion from the ESPR child abuse taskforce. Pediatr Radiol 2023; 53:739-751. [PMID: 36879046 PMCID: PMC10027646 DOI: 10.1007/s00247-023-05618-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 03/08/2023]
Abstract
This second roundtable discussion was convened at the 56th European Society of Paediatric Radiology (ESPR) 2022 Annual Meeting in Marseille, France, to discuss controversial aspects of imaging in child abuse. The following topics were discussed: Fracture dating-the published literature is broadly similar with respect to the identification of the radiographic stages of bony healing. The non-expert/general radiologist is encouraged to use broad descriptors of fracture healing (acute, healing or old) within their reports, rather than attempting to date fractures. The more experienced/expert radiologist, who may provide a timeframe/range to assist the courts, should be aware that any published timeframes are not absolute and that recent research indicates that the rate of healing may differ according to the bone affected and the age of the patient. Whole spine imaging in suspected abusive head trauma-this is recommended to enable a complete assessment of the neuraxis when abusive head trauma is suspected or diagnosed, particularly in the presence of intracranial and cervical subdural haemorrhage and cervical ligamentous injury. Cranial imaging in suspected physical abuse-both computed tomography (CT) and magnetic resonance imaging (MRI) remain complimentary depending on the clinical context in which they are used with CT remaining first-line in the assessment of children with (suspected abusive) head trauma prior to an early MRI. MRI is superior in its assessment of parenchymal injury and may be employed as first-line in age appropriate asymptomatic siblings of a child with suspected physical abuse.
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Affiliation(s)
- Michael Paddock
- Medical Imaging Department, Perth Children's Hospital, Perth, WA, Australia.
- Division of Paediatrics, University of Western Australia, Perth, WA, Australia.
- Department of Oncology & Metabolism, University of Sheffield, Sheffield Children's NHS Foundation Trust, Sheffield, UK.
| | - Arabinda K Choudhary
- Department of Diagnostic Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Annmarie Jeanes
- Department of Paediatric Radiology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Inès Mannes
- Paediatric Radiology Department, AP-HP, Bicêtre Hospital, Le Kremlin-Bicêtre, Paris, France
| | - Maria Raissaki
- Radiology Department, Medical School, University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Catherine Adamsbaum
- Faculty of Medicine, Paris-Saclay University, Le Kremlin Bicêtre, Paris, France
| | - Maria I Argyropoulou
- Department of Radiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Amaka C Offiah
- Department of Oncology & Metabolism, University of Sheffield, Sheffield Children's NHS Foundation Trust, Sheffield, UK
- Department of Radiology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
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Lynøe N, Eriksson A. Is the procedure of diagnosing abusive head trauma a purely medical matter? Pediatr Radiol 2019; 49:422-423. [PMID: 30783699 DOI: 10.1007/s00247-019-04344-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/27/2018] [Accepted: 01/10/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Niels Lynøe
- Stockholm Centre for Healthcare Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Anders Eriksson
- Department of Community Medicine and Rehabilitation/Forensic Medicine, Umeå, Sweden
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Choudhary AK, Narang SK, Moreno JA, Christian CW, Servaes S, Palusci VJ, Hedlund GL, Dias MS, Nelson MD, Silvera VM, Palasis S, Raissaki M, Rossi A, Offiah AC. A consensus response on the complete picture: reply to Lynøe and Eriksson. Pediatr Radiol 2019; 49:424-428. [PMID: 30783700 DOI: 10.1007/s00247-019-04341-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 01/07/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Arabinda Kumar Choudhary
- Department of Radiology, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA.
| | - Sandeep K Narang
- Child Abuse Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Cindy W Christian
- Department of Pediatrics, Child Abuse and Neglect Prevention, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA
| | - Sabah Servaes
- Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Gary L Hedlund
- Department of Medical Imaging, Primary Children's Hospital, Salt Lake City, UT, USA.,Department of Radiology, Intermountain Healthcare, Salt Lake City, UT, USA.,University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Mark S Dias
- Departments of Neurosurgery and Pediatrics, Penn State Health Children's Hospital, Hershey, PA, USA
| | - Marvin D Nelson
- Department of Radiology, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | | | - Susan Palasis
- Pediatric Neuroradiology, Children's Healthcare of Atlanta, Scottish Rite Campus, Atlanta, GA, USA.,Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Maria Raissaki
- Department of Radiology, University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Andrea Rossi
- Neuroradiology Unit, Istituto Giannina Gaslini Children's Hospital, Genoa, Italy
| | - Amaka C Offiah
- Paediatric Musculoskeletal Imaging, Academic Unit of Child Health, Sheffield, UK.,Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, UK.,University of Sheffield, Sheffield, UK
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Affiliation(s)
- Peter J Strouse
- Section of Pediatric Radiology, C. S. Mott Children's Hospital, Room 3-231,Department of Radiology, University of Michigan Health System, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4252, USA.
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