This booklet provides guidelines for the use of diagnostic imaging in medical evaluations designed to determine whether or not an injury is evidence of child abuse.
In cases of child abuse and neglect, the overall incidence of physical alterations that can be documented by diagnostic imaging is relatively small; however, imaging studies are often critical for infants and young children with evidence of physical injury, and they may also be the first indication of abuse in a child who is seen initially for an apparent natural illness. Since most conventional imaging studies performed in this setting are noninvasive and entail minimal radiation risks, recommendations regarding imaging should focus on examinations that provide the highest diagnostic yield at acceptable costs and should consider their potential use as courtroom evidence of child abuse. The pros and cons of various imaging techniques are discussed for skeletal injuries, intracranial injuries, and thoracoabdominal trauma. General investigative guidelines suggest when cranial computed tomography (CT) is the most suitable diagnostic tool and when magnetic resonance imaging (MRI) would be the better diagnostic tool. A separate section discusses the diagnosis of shaken baby syndrome, which refers to the intracranial injuries that result from the severe intentional application of violent force (shaking). Topics addressed in this discussion are the mechanism of injury, indicators and symptoms, diagnostic recommendations (with attention to diagnostic imaging), and investigative guidelines. 5 supplemental readings and 16 organizational resources
Date Published: March 1, 2000