Related Experiment Video

Updated: Jul 30, 2025

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
07:56

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts

Published on: January 29, 2018

17.6K

Occult fractures detected on radiographs in young children with a concern for abusive head trauma

Eliska Popelova1, Zuzana Holubova1, Marcela Dvorakova1

  • 1Department of Radiology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.

Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
|May 18, 2023
PubMed

Insights

The incidence of abusive head trauma in young children is low, but occult fractures are missed in one-third of cases when dedicated skeletal radiographs are not used. Increased awareness of imaging protocols is crucial for accurate diagnosis of child abuse.

Area of Science:

  • Pediatric Radiology
  • Child Abuse Forensics
  • Traumatology

Background:

  • Abusive head trauma (AHT) is a significant concern in young children.
  • Accurate diagnosis relies on comprehensive clinical and imaging evaluation.
  • Dedicated skeletal radiographs are essential for detecting fractures indicative of abuse.

Purpose of the Study:

  • To determine the incidence of suspected abusive head trauma in children under 2 years old.
  • To evaluate the utilization of dedicated skeletal radiographs in this population.
  • To assess the frequency of clinically occult fractures on these radiographs.

Main Methods:

  • Retrospective single-center study of children under 2 years with traumatic brain injury.
  • Data collected from December 31, 2012, to December 31, 2020.
  • Inclusion of clinical, demographic data, and review of imaging by pediatric radiologists.

Main Results:

  • 26 children (median age 3 months) were included; 42% had a traumatic history, 54% had bruises, and 69% had neurological abnormalities.
  • Dedicated skeletal radiographs were performed in 62% of cases; 31% of these revealed clinically occult fractures.
  • The majority (83%) of occult fractures had high specificity for abuse.

Conclusions:

  • The incidence of suspected abusive head trauma in children under 2 is low.
  • Clinically occult fractures are identified in one-third of children with dedicated skeletal radiographs, with high specificity for abuse.
  • Inadequate use of skeletal imaging may lead to missed fracture diagnoses; improved adherence to imaging protocols is recommended.
Abstract

Keywords:
abuseabusive head traumachildrenfractureimagingnon-accidental injury

More Related Videos

Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects07:35

Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects

Published on: April 11, 2012

18.4K
Assessment of Bone Fracture Healing Using Micro-Computed Tomography12:04

Assessment of Bone Fracture Healing Using Micro-Computed Tomography

Published on: December 9, 2022

1.9K

Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
3.4K
X-ray Imaging01:24

X-ray Imaging

German physicist Wilhelm Röntgen (1845–1923) was experimenting with electrical current when he discovered that a mysterious and invisible "ray" would pass through his flesh but leave an outline of his bones on a screen coated with a metal compound. In 1895, Röntgen made the first durable record of the internal parts of a living human: an "X-ray" image (as it came to be called) of his wife’s hand. Scientists worldwide quickly began their own experiments with...
5.7K
Radiological Investigation I: X-ray and CT01:30

Radiological Investigation I: X-ray and CT

Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
304
Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
220
Flail Chest-I01:24

Flail Chest-I

Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
233