Recognizing Child Abuse in Radiology PDF
Preview Recognizing Child Abuse in Radiology
Recognizing Child Abuse in Radiology Alan E. Oestreich Marguerite M. Caré 123 Recognizing Child Abuse in Radiology Alan E. Oestreich (cid:129) Marguerite M. Caré Recognizing Child Abuse in Radiology Alan E. Oestreich Marguerite M. Caré Department of Radiology ML5031 Department of Radiology ML5031 Cincinnati Children’s Hospital Cincinnati Children’s Hospital Cincinnati Cincinnati Ohio Ohio USA USA ISBN 978-3-319-44322-5 ISBN 978-3-319-44324-9 (eBook) DOI 10.1007/978-3-319-44324-9 Library of Congress Control Number: 2016953298 © Springer International Publishing Switzerland 2017 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. T he publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland To Our families And In the hope that this book may benefi t all vulnerable families Foreword The child abuse physician’s task is to identify those children who have been victims of child abuse and to then coordinate a multidisciplinary response needed to protect them from further harm. Most cases of suspected child abuse lack a gold standard diagnostic test, but we have learned that accurate determination of abuse can be made through a tight collaboration between skilled clinicians, radiologists, and community protective investigators. The radiologic evaluation for child abuse is unlike any other clinical scenario. Most of the children evaluated for suspected physical child abuse are too young to tell their story, may fi rst come to our attention following a delay in medical care, and present to us with confl icting histories told by caregivers. Often the clinical history is either entirely lacking or we believe it to be completely false. Thus, radiographic interpretation of suspected trauma is hindered by the absence of a reliable history and often the lack of physical disability or cutaneous signs of injury. Not only are these conditions challenging to the radiologist, but unconscious bias can also affect our assumptions and interpretation. The authors of this book have been active members of the Cincinnati Children’s Child Abuse Team for decades and have interpreted the fi lms of thousands of chil- dren for whom child abuse was suspected. They have participated in weekly multi- disciplinary case discussions, demonstrated radiographic fi ndings, and taught using language that is accessible to nonmedical investigators. Drs. Oestreich and Caré are experts in threading their way within uncertainty, informing about their level of certainty and the timing of injuries while avoiding at times the excessive demands of police offi cers and prosecutors for answers. T his book is intended to share this learned wisdom with other radiologists, as well as other interested health care practitioners including us child abuse pediatri- cians. The informed interpretation and opinions of the radiologist are critical to the recognition and protection of abused children. Not only must we accurately diag- nose child abuse to protect children from imminent harm or death but child abuse is vii viii Foreword a leading risk factor for developmental delay, child and adult mental and physical illness, and shortened life expectancy. This text will improve our capacity to change the outcome for many families and children. Robert A. Shapiro, M.D. Division Director Mayerson Center for Safe and Healthy Children Cincinnati, Ohio Clinical Professor of Pediatrics University of Cincinnati College of Medicine Pref ace The authors welcome their readers to this book intended to highlight imaging fi nd- ings in children who may be victims of child abuse, previously suspected or not, as well as imaging fi ndings that might be confused with child abuse, either normal or due to other conditions. Emphasis is on our personal experience over many years, as well as selected pertinent readings in the literature. We hope this approach will supplement and provide some additional insights to the more comprehensive larger works on these topics. Alan Oestreich, M.D., is the author of Chaps. 1 , 2 , 3 , 4 , 5 and 8 , while Marguerite M. Caré, M.D., is the author of Chaps. 6 and 7 . Both are pediatric radiologists, and she is also a pediatric neuroradiologist. T he authors thank Glenn Miñano for assistance with image preparation, Joanne (Toni) Lovelace and Kathy Umberg for secretarial assistance, and our colleagues in the Cincinnati Children’s Hospital Child Abuse Team and the Department of Radiology for years of collaboration and support. AEO and MMC ix
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