Guidelines for skeletal surveys in suspected child abuse
Introduction Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misd...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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OsloMet — Oslo Metropolitan University
2014-12-01
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| Series: | Radiography Open |
| Subjects: | |
| Online Access: | https://journals.hioa.no/index.php/radopen/article/view/1190 |
| _version_ | 1818493530378600448 |
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| author | Bo Redder Mussmann Mette Ramsdal Paulsen |
| author_facet | Bo Redder Mussmann Mette Ramsdal Paulsen |
| author_sort | Bo Redder Mussmann |
| collection | DOAJ |
| description | Introduction
Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misdiagnosis are serious. Should head trauma or fractures be overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. Conversely, where no abuse has taken place, but the certainty of the diagnosis is questionable, the unnecessary hospitalization of an innocent family may result.
In Southern Denmark approximately 15-20 children per year are examined. The examinations are performed in four different radiology departments throughout the region. Until the autumn of 2012, a variety of imaging protocols and techniques were used in pediatric skeletal surveys. This led to difficulties, because some cases are subject to second opinion report. In many cases, supplemental images or a complete reexamination of the child was required in order to facilitate a second opinion, resulting in unnecessary exposure.
Methods
An initial consensus meeting with 20 participants was arranged in 2012. Pediatric radiologists, managers and radiographers with special competencies in pediatric radiology attended. Research evidence, cases and clinical experience was discussed.
A follow-up meeting was arranged in 2013 with similar participants. This second meeting focused mainly on follow-up skeletal surveys in children <2 years of age
Results
The first meeting resulted in the agreement on which projections to acquire, image quality criteria, how to cooperate with the parents, radiologic evaluation criteria and the role of the radiographer in imaging the abused child. The second meeting resulted in consensus on the necessary projections required for follow-up skeletal surveys.
Conclusion
Common protocols for child abuse imaging have been established and fully implemented in the Region of Southern Denmark. Annual meetings have also been established where legal aspects, best practice and best evidence in imaging and cooperation with pediatric departments is discussed. |
| first_indexed | 2024-12-10T17:56:33Z |
| format | Article |
| id | doaj.art-24989b63c0494c52ae0e52877ab256b9 |
| institution | Directory Open Access Journal |
| issn | 2387-3345 |
| language | English |
| last_indexed | 2024-12-10T17:56:33Z |
| publishDate | 2014-12-01 |
| publisher | OsloMet — Oslo Metropolitan University |
| record_format | Article |
| series | Radiography Open |
| spelling | doaj.art-24989b63c0494c52ae0e52877ab256b92022-12-22T01:38:55ZengOsloMet — Oslo Metropolitan UniversityRadiography Open2387-33452014-12-01117710.7577/radopen.11901190Guidelines for skeletal surveys in suspected child abuseBo Redder MussmannMette Ramsdal PaulsenIntroduction Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misdiagnosis are serious. Should head trauma or fractures be overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. Conversely, where no abuse has taken place, but the certainty of the diagnosis is questionable, the unnecessary hospitalization of an innocent family may result. In Southern Denmark approximately 15-20 children per year are examined. The examinations are performed in four different radiology departments throughout the region. Until the autumn of 2012, a variety of imaging protocols and techniques were used in pediatric skeletal surveys. This led to difficulties, because some cases are subject to second opinion report. In many cases, supplemental images or a complete reexamination of the child was required in order to facilitate a second opinion, resulting in unnecessary exposure. Methods An initial consensus meeting with 20 participants was arranged in 2012. Pediatric radiologists, managers and radiographers with special competencies in pediatric radiology attended. Research evidence, cases and clinical experience was discussed. A follow-up meeting was arranged in 2013 with similar participants. This second meeting focused mainly on follow-up skeletal surveys in children <2 years of age Results The first meeting resulted in the agreement on which projections to acquire, image quality criteria, how to cooperate with the parents, radiologic evaluation criteria and the role of the radiographer in imaging the abused child. The second meeting resulted in consensus on the necessary projections required for follow-up skeletal surveys. Conclusion Common protocols for child abuse imaging have been established and fully implemented in the Region of Southern Denmark. Annual meetings have also been established where legal aspects, best practice and best evidence in imaging and cooperation with pediatric departments is discussed.https://journals.hioa.no/index.php/radopen/article/view/1190Battered child syndromeConsensus developmentExposure techniqueFractureImage qualityNon-accidental injuryLead markerPatient handlingPediatric radiographyRadiographySide markerSkeletal survey |
| spellingShingle | Bo Redder Mussmann Mette Ramsdal Paulsen Guidelines for skeletal surveys in suspected child abuse Radiography Open Battered child syndrome Consensus development Exposure technique Fracture Image quality Non-accidental injury Lead marker Patient handling Pediatric radiography Radiography Side marker Skeletal survey |
| title | Guidelines for skeletal surveys in suspected child abuse |
| title_full | Guidelines for skeletal surveys in suspected child abuse |
| title_fullStr | Guidelines for skeletal surveys in suspected child abuse |
| title_full_unstemmed | Guidelines for skeletal surveys in suspected child abuse |
| title_short | Guidelines for skeletal surveys in suspected child abuse |
| title_sort | guidelines for skeletal surveys in suspected child abuse |
| topic | Battered child syndrome Consensus development Exposure technique Fracture Image quality Non-accidental injury Lead marker Patient handling Pediatric radiography Radiography Side marker Skeletal survey |
| url | https://journals.hioa.no/index.php/radopen/article/view/1190 |
| work_keys_str_mv | AT boreddermussmann guidelinesforskeletalsurveysinsuspectedchildabuse AT metteramsdalpaulsen guidelinesforskeletalsurveysinsuspectedchildabuse |