The abused child: a radiological reappraisal.

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Abstract
Radiological findings in 563 abused infants and children who were studied retrospectively emphasize the limitations of diagnostic imaging, specifically radiographic examination of the skeleton. Skeletal trauma was detected in < 1/3 of all patients and was uncommon beyond 2 yr of age. Fractures were rarely present without clinical evidence of physical abuse. Radiographic features considered specific for child abuse (epiphyseal-metaphyseal, rib fractures) or highly suggestive (occult, multiple/repetitive fractures) were distinctly infrequent and limited to infancy. A more efficacious approach to radiological evaluation based on clinical presentation is offered.

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