A literature review of ‘best practice’ for radiographers when imaging suspected non-accidental injury or physical abuse of children in Australia and New Zealand

Doyle, Edel; Vuong, Raymond

doi:10.1016/j.jofri.2019.09.001

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Abdominal imaging methods in the context of suspected child abuse are not clearly codified, and recommendations vary considerably from one country to another. Recommendations in countries such as the United States, the United Kingdom, New Zealand, and Australia favored the use of initial IV-CT in the event of clinical and/or biological signs (Chauvin-Kimoff et al, 2018; Christian & Committee on child abuse and neglect, 2015; Doyle & Vuong, 2020; Family Violence Assessment and Intervention Guideline: Child abuse and intimate partner violence | Ministry of Health NZ, n.d.; Manager, n.d.; Paddock et al, 2018; Section on Radiology, 2009; Wootton-Gorges et al, 2017). The Korean recommendations suggest the use of IV-CT in cases of vital distress or deterioration of the hepatic or pancreatic assays but the use of US in the event of weak suspicion of abdominal injury (Jeon et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Relevance of Routine Abdominopelvic Ultrasound in Suspected Child Abuse in Children Under 2 years of Age: Review of 15 years of Experience

et al. 2021

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In France, the current recommendation is to perform a routine abdominopelvic ultrasound in any child under 2 years of age who is suspected to have been abused. We retrospectively studied the relevance of this practice in our center over the past fifteen years. This was a descriptive, retrospective study of all children under 2 years of age who had been subject to suspected abuse. Abdominal images and reports were reviewed and cross-referenced with possible clinical and biological signs. Four hundred and five children were included between 2006 and 2020, of whom 296 underwent abdominal imaging (2 initial abdominopelvic CT scans, 4 ultrasounds followed by CT scans, and 290 ultrasounds alone). Four examinations revealed traumatic abnormalities related to abuse. These four children all had clinical or biological anomalies. In the absence of clinical or biological signs, no imagery showed any abnormality related to abuse.

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Section: Discussionmentioning

confidence: 99%

Relevance of Routine Abdominopelvic Ultrasound in Suspected Child Abuse in Children Under 2 years of Age: Review of 15 years of Experience

et al. 2021

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“…Among the available protocols for skeletal surveys, the American College of Radiology-Society for Pediatric Radiology (ACR-SPR) survey [ 77 ], and The Society and College of Radiographers-The Royal College of Radiologists (SCoR-RCR) [ 80 ], survey is fairly accepted protocols and used internationally in various healthcare systems [ 81 ]. As per the SCoR-RCR protocol, a follow-up skeletal survey containing only a fraction of the original views, should ideally be completed within 11-14 days [ 81 ], of initial imaging, to potentially uncover further injuries or to determine the age of the fractures [ 78 ]. A delay of more than 28 days may result in the need to perform a complete skeletal survey instead of a follow-up one [ 80 ].…”

Section: Reviewmentioning

confidence: 99%

A Multispecialty Approach to the Identification and Diagnosis of Nonaccidental Trauma in Children

Manan¹,

Rahman²,

Komer³

et al. 2022

Cureus

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Child abuse is a preventable phenomenon of considerable concern resulting in significant child mortality and morbidity. We analyze various abuse lesions such as radiological (visceral and skeletal lesions and those associated with head trauma) and cutaneous (burns, bruises, bites, etc.) to enhance streamlined identification of injuries in cases of physical child abuse. For effective results, it is essential to remain mindful of all background factors, such as the caregiver setting and the prevalence of child maltreatment in the concerned community while acknowledging the possibility of natural causes (genetic diseases such as osteogenesis imperfecta and hemophilia, or acquired abnormalities) that can mimic NAT and cause confusion in diagnosis and treatment. The margin of error in cases of abuse is negligible, therefore, making its diagnosis a momentous as well as challenging clinical task. An ineffective diagnosis can have detrimental emotional consequences for the family and may even expose the child to future potentially fatal episodes of abuse. Hence, there is a need to direct special focus on the importance of accurate history taking and immediate, responsible reporting to authorities, as well as to child protective services. Therefore, considering the multifactorial approach this subject requires, this review aims to delve into prevalence statistics, various risk factors, and their effect on psychological health to offer a near-complete regulation to ensure an effective understanding of NAT on part of doctors, social workers, and other relevant authorities.

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“…Diagnostic medical imaging is instrumental in the diagnosis of suspected physical abuse (SPA) in infants and young children. As the first health care professionals to view any radiographic imaging obtained, radiologic technologists (health care professionals who are trained and qualified to perform diagnostic imaging examinations using various imaging modalities, also known as radiographers or technicians) play a crucial role in raising the suspicion of SPA to colleagues and radiologists through the identification of the suspicious radiographic findings such as rib and metaphyseal fractures, multiple fractures at different stages of healing [ 8 ], and potentially inappropriate interactions between caregivers and the child [ 9 ]. Clinical radiologists (specialist medical doctors who are trained and qualified to interpret and report upon medical imaging to diagnose injuries and diseases) play a pivotal role in SPA through the identification and reporting of acute and healing fractures when physical abuse is not suspected or when injuries are not clinically apparent (occult) or disclosed (e.g., intracranial haemorrhage) [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Professional practice and awareness of child abuse among radiologists and radiologic technologists: results from Saudi Arabia

et al. 2022

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Background The knowledge, awareness and professionalism of health care providers in the field of child protection are crucial in identifying and reporting suspected child abuse. Radiologic technologists and radiologists play a vital role in the diagnosis of suspected physical child abuse. Objective To assess current practice, knowledge and awareness of child abuse among radiologic technologists and radiologists in Saudi Arabia. Materials and methods We distributed an internet-based questionnaire to radiologic technologists and radiologists working in Saudi Arabia via national radiology societies and social media channels over a 6-week period (27 October to 8 December 2021). Survey questions covered knowledge regarding child abuse, professional practice in radiology departments in Saudi Arabia in cases of suspected physical abuse (SPA), and knowledge of the national legislation and reporting and acting procedures in child abuse. Results A total of 315 respondents (224 radiologic technologists and 91 radiologists) participated in this study. The median score for knowledge of abuse was higher amongst radiologists (4.8) than radiologic technologists (4.0); P < 0.001. In total, 210 (93.8%) radiologic technologists and 61 (67.0%) radiologists reported that there was no protocol (i.e. skeletal survey) at their hospital for imaging children with SPA. Most radiologic technologists had no training in paediatric radiology (165/224, 73.7%) and most radiologists had received no training in evaluating imaging performed for SPA (73/91, 80.2%). More than half of respondents — 131 (58.5%) radiologic technologists and 44 (48.4%) radiologists — were not familiar with the reporting and acting procedures at their hospitals in cases of child abuse. Conclusion Although radiologic technologists and radiologists in Saudi Arabia have good knowledge and awareness of child abuse in general, they lack specific knowledge of the reporting and acting procedures at their hospitals in cases of suspected child abuse. National imaging guidelines and training courses are needed to develop appropriate skills in the recognition, imaging and reporting of SPA in infants and young children in Saudi Arabia.

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A literature review of ‘best practice’ for radiographers when imaging suspected non-accidental injury or physical abuse of children in Australia and New Zealand

Cited by 6 publications

References 24 publications

Relevance of Routine Abdominopelvic Ultrasound in Suspected Child Abuse in Children Under 2 years of Age: Review of 15 years of Experience

Relevance of Routine Abdominopelvic Ultrasound in Suspected Child Abuse in Children Under 2 years of Age: Review of 15 years of Experience

A Multispecialty Approach to the Identification and Diagnosis of Nonaccidental Trauma in Children

Professional practice and awareness of child abuse among radiologists and radiologic technologists: results from Saudi Arabia

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