Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Room 1053, Indianapolis, IN, 46202, USA.
Pediatr Radiol. 2021 May;51(6):1003-1013. doi: 10.1007/s00247-020-04945-1. Epub 2021 Mar 30.
The objective of this paper is to review common challenges when evaluating fractures in the setting of possible child abuse and approaches to navigate them. This paper reviews the variety of imaging modalities available for evaluating child abuse and the advantages/disadvantages of each. Additionally, the authors discuss management of equivocal fractures, including the impact of double-reading skeletal surveys. The complexity of dating the acuity of fractures in young children is discussed. Utilizing the knowledge of fracture type, fracture patterns and patient history, as well as in the setting of cardiopulmonary resuscitation, the authors provide methods for determining the likelihood of abuse.
本文旨在回顾在疑似儿童虐待的情况下评估骨折时常见的挑战，并探讨应对这些挑战的方法。本文回顾了评估儿童虐待的各种影像学检查方法，并讨论了每种方法的优缺点。此外，作者还讨论了可疑骨折的处理方法，包括二次阅片对全身骨骼检查的影响。本文还讨论了确定幼儿骨折急性程度的复杂性。作者利用骨折类型、骨折模式和患者病史的知识，以及在心肺复苏的情况下，提供了确定虐待可能性的方法。
