Radiology in suspected non-accidental injury: theory and practice in The Netherlands

Eur J Radiol. 2009 Jul;71(1):147-51. doi: 10.1016/j.ejrad.2008.02.014. Epub 2008 Apr 8.

Abstract

Introduction: This study evaluates radiological imaging in suspected non accidental injury (NAI) in children below the age of 2 years in the Netherlands.

Material and methods: The study consisted of two parts; first an on-line questionnaire on suspected NAI, amongst radiological practices within the Netherlands. The second part of the study was a retrospective analysis of skeletal surveys in children under the age of 2 years, which were reviewed in an expert centre of forensic medicine on request of the public prosecutor.

Results: Out of 116 hospitals 45 (39%) radiologists completed the on-line questionnaire; 8 (8%) of the proposed skeletal surveys complied with the ACR criteria. A total of 29 skeletal surveys in 26 children were reviewed. The median age at the time of the radiographic exam was 3 months for both boys and girls. Only 2 (7%) studies complied with the ACR criteria.

Discussion: The results of our study show that, in theory as well as in practice, Dutch radiological practices show a large variation in imaging protocols for suspected NAI.

MeSH terms

  • Accidents
  • Child
  • Child Abuse / diagnosis*
  • Child Abuse / statistics & numerical data*
  • Child, Preschool
  • Female
  • Fractures, Bone / diagnostic imaging*
  • Fractures, Bone / epidemiology*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Netherlands / epidemiology
  • Physicians / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Radiography
  • Radiology / statistics & numerical data*
  • Risk Assessment / methods
  • Risk Factors
  • Surveys and Questionnaires