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Growth recovery lines are more common in infants at high vs. low risk for abuse

Matthew A Zapala1,2, Andy Tsai3, Paul K Kleinman3

  • 1Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Matthew.Zapala@ucsf.edu.

Pediatric Radiology
|May 6, 2016
PubMed

Insights

Growth recovery lines are significantly more prevalent in high-risk infants, indicating a higher likelihood of abuse. These lines suggest temporary disruptions in bone development due to physiological stress in abused infants.

Area of Science:

  • Pediatric Radiology
  • Skeletal Dysplasias
  • Child Abuse Detection

Background:

  • Growth recovery lines, also known as growth arrest lines, are radiodense bands in bone metaphyses.
  • They result from temporary interruptions in endochondral ossification due to various insults.
  • These lines can be indicators of underlying physiological stress or injury.

Purpose of the Study:

  • To investigate the association between growth recovery lines and the risk of abuse in infants.
  • To compare the prevalence of growth recovery lines in infants categorized as high-risk versus low-risk for abuse.

Main Methods:

  • Retrospective review of skeletal surveys from 1999-2013.
  • Infants were classified as low-risk or high-risk for abuse based on clinical findings and assessments.
  • Two blinded radiologists independently assessed knee and lower leg radiographs for growth recovery lines.

Main Results:

  • Growth recovery lines were present in 38% of low-risk infants and 71% of high-risk infants.
  • The prevalence was significantly higher in the high-risk group (odds ratio 4.0, P < 0.001).
  • This suggests a strong correlation between growth recovery lines and a higher risk of abuse.

Conclusions:

  • Growth recovery lines are significantly more common in infants at high risk for abuse.
  • This finding implies that abused infants experience episodic physiological stresses that disrupt endochondral ossification.
  • Growth recovery lines may serve as a potential imaging biomarker for detecting abuse in infants.
Abstract

Keywords:
BoneChild abuseGrowth recovery linesInfantsMetaphysisRadiographySkeletal survey

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