[Radiologic diagnosis of the battered child syndrome]

The imaging modalities play a key role in the investigation and documentation of the battered child syndrome. The primary diagnostic imaging study in suspected child abuse is either a bone scan and x-ray series or a complete radiographic skeletal survey by x-ray series in babies and infants. In expected intracranial injuries, a CT scan of the head is mandatory; ultrasound has to be performed in order to exclude visceral lesions. The conventional radiographic examination permits us to identify the appearance of the injury (periosteal bleeding and ossification, metaphyseal fragmentation, fracture and epiphysiolysis) as well as the mechanism of the lesion: direct blow, twisting or traction of a limb, compression or shaking. In addition the age of the lesion can be derived from typical healing processes of the skeleton. Furthermore, non accidental skeletal malformations can be detected and may allow the exclusion of child abuse.