Radiology of nonaccidental trauma

Abstract

The long-term outlook for infants subjected to nonaccidental trauma is bleak. In a retrospective study with a mean 9-year follow-up, Duhaime et al [63] noted the relationship between acute factors on presentation and the long-term outcome. Infants who were unresponsive on presentation remained vegetative or severely impaired at follow-up. Most of the infants who required intubations were severely impaired at follow-up. In those with acute seizures, 60% were severely impaired, and an equal number had moderately severe to good outcome. Less than 6 months of age at the time of insult resulted in severe disability in most infants. CT findings of diffuse hypodensity or loss of gray-white differentiation led to severe disability at follow-up. Focal areas of hypodensity or contusion had an equal probability of good outcome or severe disability. Child abuse unfortunately is prevalent in our society, and as physicians our profession requires that we help our patients. When dealing with one of our most vulnerable group of patients, it is imperative when a child with injury is examined that physicians keep in their differential child abuse. This article has provided information in regards to radiographic studies that assist a physician in diagnosing child abuse. The importance of this not only is in providing appropriate care, but far more importantly in protecting a child or his or her siblings from future abuse.