Radiologists, pediatricians urged to team up to find child abuse

A revised AAP policy statement says imaging studies are particularly important when screening very young children.

By Victoria Stagg Elliott — Posted May 5, 2009

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Physicians who care for children should work closely with those who perform imaging studies of various injuries in order to diagnose physical abuse correctly, according to an American Academy of Pediatrics policy statement published in the May Pediatrics.

"This approach will help ensure that child abuse is accurately identified and reliably differentiated from conditions that may simulate abuse," wrote members of the organization's section on radiology.

The authors also recommended that imaging studies be viewed in conjunction with clinical and laboratory investigations and say such information is particularly critical when evaluating infants and very young children. Full skeletal surveys are mandatory for those younger than 2 who are suspected of being physically abused and should be considered for those ages 2-5. Cranial computed tomography, magnetic resonance imaging or both can be considered for those with head injuries. The paper also cautioned that, although imaging may provide the first clues that a child is being abused, it may also suggest other possible diagnoses.

"I think [the paper] is an excellent attempt to try to improve the science of diagnosing child abuse. You want to be sure that you're truly on the right track. I don't want to minimize child abuse, but you want to be sure that, for a very emotional issue, you are accurate in the assessment," said Robert W. Stuart, MD, medical director of urgent care for Aurora Medical Group in Milwaukee. He is not affiliated with the authors.

This document also advocated that as little ionizing radiation as possible be used but added that low-resolution scans will usually not be sensitive enough to pick up some of the skeletal abnormalities caused by physical abuse. High-detail scans should be utilized.

Physicians working on violence and abuse issues stressed, however, that this technology finds evidence only of physical abuse and hope that awareness of the other forms will increase.

"We would like to have everybody fully aware of all forms of abuse and be able to diagnose it," said David McCollum, MD, board chair of the Academy on Violence and Abuse.

The last AAP policy statement on this subject was issued in June 2000.

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn