Child Abuse Part 4: Testing, Imaging and Detection

Course overview

Practitioners in primary care, particularly Pediatrics and Family Medicine, are uniquely poised to not only detect but also to prevent child abuse. In addition to primary care, practitioners in other acute-care specialties and environments bear the responsibility for early identification and reporting of suspected child abuse. These practice environments include Emergency Departments, Urgent Care centers, and clinics. Child physical abuse exists in all corners of the country and affects children of all ages, ethnicities and socioeconomic groups. The recognition and identification of child abuse is not an easy task. Not all practitioners are aware of the risk factors for abuse nor are they knowledgeable regarding the “sentinel injuries” that represent just the tip of the child abuse iceberg. In this activity, we address the guidelines for appropriate use of diagnostic studies and imaging in the evaluation of a child for possible physical abuse. We will present the case of a 6-month-old infant in whom the diagnosis of abusive head trauma was initially missed. Finally, we will provide you with guidelines for documentation and arm you with strategies to improve detection in cases of suspected child physical abuse. After completing this activity, learners should be able to: formulate a plan for diagnostic studies and imaging in cases of suspected child physical abuse; demonstrate appropriate documentation in cases of suspected child physical abuse; and utilize guidelines to decide when an infant with bruising should undergo a full child abuse workup.