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Published on: January 29, 2018
Multiple Bony Injuries on Bone Scan in a Case of Unsuspected Child Abuse
Ya-Wen Chuang1, Chien-Chin Hsu2, Chin-Chuan Chang1
1Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Insights
Child abuse can cause multiple bone injuries, even after a fall. Radionuclide bone scans revealed widespread fractures in an infant, suggesting non-accidental trauma over infection or congenital issues.
Area of Science:
- Pediatric Radiology
- Skeletal Imaging
- Child Abuse Detection
Background:
- An 11-month-old infant presented with lower limb swelling and left elbow skeletal malformation post-fall.
- Diagnostic imaging was pursued to rule out bone infection or congenital anomalies.
Observation:
- Radionuclide bone scan unexpectedly revealed multiple areas of increased radioactive uptake throughout the infant's body.
- These findings were corroborated by subsequent plain film radiographs and Magnetic Resonance Imaging (MRI).
Findings:
- The widespread skeletal abnormalities strongly indicated a high probability of child abuse.
- The pattern of injuries was inconsistent with a simple fall or congenital condition.
Implications:
- This case highlights the critical role of advanced imaging in identifying non-accidental trauma in infants.
- Early and accurate diagnosis through bone scans, radiography, and MRI is crucial for intervention and child protection.
Abstract:
This case is described of an eleven-month-old infant with lower limbs swelling and the left elbow skeletal malformation following a fall. The radionuclide bone scan was performed to exclude bone infection or congenital skeletal anomaly. The images unexpectedly showed multiple increased radioactive foci throughout the whole body. It was a strong probability of child abuse. All lesions are readily apparent on the following plain film radiographs and MRI.
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