Monday, 6 September 2010

SBS: Imaging studies

Because of the widely acknowledged controversy in
nonaccidental injury, the radiologist involved in such cases must be
thoroughly familiar with the imaging, clinical, surgical, pathological,
biomechanical, and forensic literature from all perspectives and
with the principles of evidence-based medicine. Children with
suspected nonaccidental injury versus accidental injury must not
only receive protective evaluation but also require a timely and
complete clinical and imaging workup to evaluate pattern of injury
and timing issues and to consider the mimics of abuse. All imaging
findings must be correlated with clinical findings (including current
and past medical record) and with laboratory and pathological
findings (eg, surgical, autopsy). The medical and imaging evidence,
particularly when there is only central nervous system injury, cannot
reliably diagnose intentional injury. Only the child protection
investigation may provide the basis for inflicted injury in the context
of supportive medical, imaging, biomechanical, or pathological
(Top Magn Reson Imaging 2007;18:53Y74)

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