Imaging Solutions by Clinical Scenario
Pediatric

Child Abuse

Standard imaging protocol is plain films (2 views) of the skull, spine, ribs, pelvis, and all the bones of the arms and legs. This will screen for fractures or other injury patterns suggesting abuse. This group of films is ordered as a group entitled "bone survey" instead of ordered individually. An alternative examination is a whole body single-phase bone scan, with directed films only at areas of positivity on the nuclear medicine exam. Many pediatricians will also order a head CT to screen for neurological sequelae of abuse. CT of the chest, abdomen, pelvis or elsewhere is directed by specific clinical indications if present. If significant evidence of abuse is discovered the child should be retained within the imaging department and immediate consultation with social services performed in order to protect the patient from further injury.