Nonaccidental Injury in the Elderly: What Radiologists Need to Know

Area of Science:

• Medical imaging
• Geriatrics
• Forensic medicine

Background:

• Elder abuse is prevalent and serious, yet detection and reporting rates are low.
• Diagnostic imaging is crucial for child abuse detection but underutilized for elder abuse.
• Barriers include lack of training, comorbidities, and poor communication among care providers.

Purpose of the Study:

• To review imaging features suggestive of elder abuse.
• To discuss barriers to using imaging in elder abuse cases.
• To compare elder abuse with child abuse in imaging contexts.

Main Methods:

• Review of imaging findings in elder abuse cases.
• Focus on radiography and computed tomography (CT) modalities.
• Comparison of elder abuse and child abuse imaging characteristics.

Main Results:

• Specific imaging findings like posterior rib fractures and inconsistent injury mechanisms raise concern for abuse.
• Radiography and CT are primary modalities for initial detection of abuse-related findings.
• Radiologists can identify potential elder abuse with knowledge of risk factors and imaging findings.

Conclusions:

• Increased radiologist awareness and training are needed for elder abuse detection.
• Improved clinical workflows and research are recommended to enhance participation in elder abuse detection.
• Radiologists play a key role in identifying elder abuse through correlative imaging findings.