Follow-up skeletal surveys in suspected child abuse

Paul K. Kleinman, Katherine Nimkin, Melissa R. Spevak, Shawn M. Rayder, Deborah L. Madansky, Yvonne A. Shelton, Miki M. Patterson

Research output: Contribution to journalArticlepeer-review

150 Scopus citations


OBJECTIVE. The purpose of this study was to assess the additional yield of a repeat skeletal survey in identifying and dating skeletal injury for cases in which child abuse was strongly suspected. MATERIALS AND METHODS. Twenty-three infants and toddlers strongly suspected of being physically abused on the basis of findings on the initial skeletal survey, other imaging studies, history, or physical examination underwent a follow-up examination approximately 2 weeks after the initial examination. The high-detail imaging system included a single-emulsion, single-screen combination with a low absorption carbon-fiber cassette. The skeletal survey protocol entailed tightly collimated anteroposterior views of the appendicular skeleton and anteroposterior and lateral views of the axial skeleton. Between the two studies, all children were in Department or Social Services custody or living in a safe home. RESULTS. The follow-up skeletal survey yielded additional information regarding skeletal injury in 14 (61%) of 23 cases. Follow-up study increased the number of definite fractures detected from 70 to 89 (27%) (p = .005). Most of these additional injuries were classic metaphyseal lesions or rib fractures. In 13 of the 70 fractures previously detected, the follow-up skeletal survey also provided important information about the age of those injuries. CONCLUSION. When child abuse is strongly suspected on the basis of the findings on the initial skeletal survey, other imaging studies, history, or physical examination, a follow-up skeletal survey is recommended to provide a thorough and accurate assessment of osseous injuries.

Original languageEnglish (US)
Pages (from-to)893-896
Number of pages4
JournalAmerican Journal of Roentgenology
Issue number4
StatePublished - 1996
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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