Abstract
Background
Neuroimaging can be an important part of the medical workup for children with suspected
physical abuse, but there are not specific guidelines on which children should undergo
neuroimaging.
Objective
We sought to evaluate the yield of neuroimaging in children <12 months of age who
are undergoing physical abuse evaluations and to determine how the yield varied by
age, injuries, and social risk factors.
Methods
This was a retrospective observational study of infants who presented to an urban
children's hospital between September 2007 and October 2012, were evaluated by the
hospital's child abuse team, and who received skeletal surveys and underwent neuroimaging
for suspected physical abuse. Infants who were diagnosed with head trauma before the
abuse evaluation were excluded. Logistic regression was used to investigate the relationship
between neuroimaging yield and patient age, presenting injury, and social features.
Results
Head injuries were identified in 14 of 170 infants (8.2%). The yield was similar in
children <6 months of age and children ≥6 months of age (7.5% and 9.4%, respectively;
p = 0.674). Infants with bruises and cases involving a delay in seeking care or cases
with previous Child Protective Services involvement were more likely to have injuries
identified on neuroimaging. Infants with current or past neurologic signs/symptoms
were also more likely to have head injuries on neuroimaging (5/17, 29%), although
most infants with abnormal neuroimaging findings did not have neurologic signs/symptoms
(9/14, 64%).
Conclusions
We found that while certain features were associated with abnormal findings on neuroimaging,
infant age (<6 months vs. 6-12 months) was not.
Keywords
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Article info
Publication history
Published online: June 03, 2019
Accepted:
March 27,
2019
Received in revised form:
March 22,
2019
Received:
February 11,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
