Radiographic dating definition
The radiologist may be the first to raise a question of abuse if characteristic or unexplained findings are encountered during imaging.Immediate, direct communication with the referring physician is imperative in such cases.Caffey's landmark article of 1946 noted an association between healing long-bone fractures and chronic subdural hematomas in infancy, and it was the first to draw attention to physical abuse as a unifying etiology.Since these early reports, investigators have more clearly defined the pathophysiology of abusive injuries (see the images below).
A radiologist's testimony regarding findings of possible abuse may be required, and the radiologist may be asked to give an opinion as to the likely age of the child's fractures and about the possibility of alternative diagnoses.
Familiarity with radiographic patterns and mechanisms of abuse generally allows the radiologist to give an interpretation with a high degree of certainty.
If such correlation is not performed, important clues of an inflicted injury may be overlooked, and the child may be returned to an abusive environment—with potentially disastrous consequences.
The radiologist has important medical and legal roles in cases of child abuse.
Community-service and law-enforcement authorities have taken a role in protecting potential victims and in prosecuting perpetrators. Image shows multiple bilateral rib fractures that are healing. Nonenhanced head CT scan shows a left parieto-occipital contusion, a subdural hygroma, a skull fracture, and swelling of the scalp.Note the callus formation at the posterior and lateral aspects of the ribs and the healing left clavicular fracture with callus formation. A variety of injuries may occur as a result of child abuse.