Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal.
Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal.
复制标题
回顾性审查以确定在正常骨骼调查时，在虐待儿童评估中随访骨骼调查的效用。
DOI：
10.1186/1756-0500-4-354
复制
发表时间：
2011-09-12
影响因子：
1.8
通讯作者：
Mahabee-Gittens M
中科院分区：
文献类型：
--
作者：
Bennett BL;Chua MS;Care M;Kachelmeyer A;Mahabee-Gittens M
美国儿科学会建议对所有强烈怀疑是虐待受害者的24个月以下的儿童进行后续骨骼调查。本研究的目的是评估在初始骨骼调查正常的情况下，后续骨骼调查在疑似儿童身体虐待评估中的效用。回顾性回顾了1998年9月1日至2007年1月31日的放射学记录。年龄小于24个月并在56天内接受初步和后续骨骼调查的疑似儿童虐待受害者被纳入研究。最初骨骼调查阴性的儿童被纳入进一步分析。47名儿童最初骨骼调查呈阴性，并纳入分析。平均年龄6.9个月（SD 5.7）；骨骼调查的平均间隔天数为18.7天（SD 10.1）。4名儿童（8.5%）在随访骨骼调查中出现骨创伤愈合的迹象。其中3名患儿（75%）肋骨骨折愈合，1名患儿肱骨近端骨折愈合。随访的骨骼调查结果为所有4例病例提供了重要的法医信息，并加强了非意外创伤的诊断。8.5%最初骨骼调查阴性的儿童在后续骨骼调查中有重要的法医发现，增加了非意外创伤诊断的确定性。即使最初的骨骼调查结果为阴性，后续的骨骼调查也是有用的。
The AAP recommends that a follow-up skeletal survey be obtained for all children < 24 months of age who are strongly suspected to be victims of abuse. The objective of the current study was to evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations when the initial skeletal survey is normal. A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were < 24 months of age and received initial and follow-up skeletal surveys within 56 days were enrolled in the study. Children with a negative initial skeletal survey were included for further analysis. Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7); the mean number of days between skeletal surveys was 18.7 (SD 10.1) Four children (8.5%) had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75%) had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma. 8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative.