Contact: Jim Feuer, Children's Hospital, Cincinnati
[email protected]; 513-636-4420
Embargo: Sunday, May 14, 4:45 pm
A new Children's Hospital Medical Center of Cincinnati study is helping child abuse experts evaluate alleged cases of child physical abuse.
The study found that follow-up X-rays of alleged victims taken two or more weeks after the original evaluation yielded additional information -- in some cases previously undetected broken bones -- in 48 percent of cases studied. Because of the study, Cincinnati Children's now takes follow-up X-rays of virtually all alleged victims of child physical abuse who are evaluated at the medical center.
"Many injuries are hard to pick up on initial examination," says Stephanie Zimmerman, M.D., an emergency medicine physician at Cincinnati Children's. "But if there has been an injury to bone, new bone builds up around the injured area. Two weeks later, you can see those that have healed, enabling us to pick up the injury a second time."
The researchers studied 27 children under the age of 4 who were suspected victims of physical child abuse. Two weeks after their initial examination, identical X-rays were taken again, except for X-rays of the skull, which were omitted.
These follow-up X-rays yielded new information in 13 of the 27 cases. Fourteen previously undetected fractures were seen on the follow-up studies of seven patients. In addition, the initial X-rays of nine children revealed 11 possible extremity fractures and five possible rib fractures. Follow-up examinations, however, confirmed only three extremity fractures. In four cases, the impression of child abuse was reversed based on the findings of the follow-up X-rays, according to Dr. Zimmerman.
"Repeat skeletal surveys are a valuable addition in the evaluation of alleged child physical abuse," says Dr. Zimmerman. "Because these radiographs may reveal new fractures and/or clarify questionable fractures, physicians will be able to more accurately diagnose or exclude child physical abuse."
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