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ACR Appropriateness Criteria® Suspected Physical Abuse-Child: Update 2025.

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Summary
This summary is machine-generated.

Radiographic skeletal surveys and head CT scans are crucial for detecting physical abuse in young children. Imaging protocols are tailored based on age and symptoms to identify occult fractures and internal injuries.

Keywords:
AUCAppropriate Use CriteriaAppropriateness CriteriaCNS injurychildreninfantssuspected physical abusetoddlersvisceral injury

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Area of Science:

  • Pediatric Radiology
  • Forensic Imaging
  • Child Abuse Detection

Background:

  • Suspected physical abuse in children requires prompt and accurate diagnostic imaging.
  • Imaging guidelines vary based on the child's age and clinical presentation.
  • Identifying occult injuries is critical for diagnosis and intervention.

Purpose of the Study:

  • To outline appropriate imaging strategies for suspected physical abuse in infants and children.
  • To detail the role of various imaging modalities in detecting fractures and internal injuries.
  • To emphasize evidence-based guidelines for pediatric forensic imaging.

Main Methods:

  • Review of American College of Radiology Appropriateness Criteria.
  • Application of GRADE methodology for evidence evaluation.
  • Utilizing the RAND/UCLA Appropriateness Method for clinical scenarios.
  • Expert consensus for cases with limited literature.

Main Results:

  • Skeletal surveys and noncontrast head CT are first-line for infants (<24 months) to detect occult fractures and intracranial hemorrhages.
  • For older children (>24 months), imaging is targeted, with skeletal surveys used selectively.
  • Contrast-enhanced abdominal CT is recommended for suspected visceral injuries.
  • Repeat skeletal surveys can identify healing injuries.

Conclusions:

  • Age-specific imaging protocols are essential for evaluating suspected child abuse.
  • Noncontrast head CT and skeletal surveys are fundamental for early detection of injuries.
  • Imaging guidelines aid in the appropriate and timely diagnosis of physical abuse in pediatric patients.