Email updates

Keep up to date with the latest news and content from BMC Research Notes and BioMed Central.

Open Access Research article

Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal

Berkeley L Bennett1*, Michael S Chua1, Marguerite Care2, Andrea Kachelmeyer1 and Melinda Mahabee-Gittens1

Author affiliations

1 Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio USA

2 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio USA

For all author emails, please log on.

Citation and License

BMC Research Notes 2011, 4:354  doi:10.1186/1756-0500-4-354

Published: 12 September 2011

Abstract

Objective

The AAP recommends that a follow-up skeletal survey be obtained for all children < 24 months of age who are strongly suspected to be victims of abuse. The objective of the current study was to evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations when the initial skeletal survey is normal.

Methods

A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were < 24 months of age and received initial and follow-up skeletal surveys within 56 days were enrolled in the study. Children with a negative initial skeletal survey were included for further analysis.

Results

Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7); the mean number of days between skeletal surveys was 18.7 (SD 10.1)

Four children (8.5%) had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75%) had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma.

Conclusion

8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative.

Keywords:
Skeletal survey; Non-accidental trauma; Child Abuse; Follow-up