[Screening of contact children in suspected cases of child physical abuse]

Abstract

Objective: To describe the association between suspected physical abuse in an index child and the risk of abuse among contact children, and to translate the recent international consensus on recommended screening protocols for contact children into clinical practice.

Results: There is strong evidence of a link between abuse in an index child and risk to other children in close contact - such as siblings or those cared for by the same caregiver - especially children under 2 years and twins. The consensus recommends the following radiological screening protocol: All contact children: top-to-toe physical examination and clinical history intake. Age < 12 months: top-to-toe exam, full skeletal survey, and neuroimaging (preferably MRI and myelum). Age 12-24 months: top-to-toe exam and full skeletal survey. Age > 24 months: no routine imaging indicated unless clinically warranted. Expert evaluation by a pediatric forensic radiologist is advised; re-evaluation by a LECK radiologist is recommended.

Conclusion: Contact children of a physical abused index child are at heightened risk and require proactive radiological screening according to the international consensus protocol. Interpretation of imaging should involve specialists in forensic pediatric radiology to ensure diagnostic accuracy and safeguard vulnerable children.