Evidence-based imaging in non-CNS nonaccidental injury

Key Points: □ Child abuse is a serious health problem with severe long-term consequences and high societal costs (strong evidence). □ Child abuse is both underdetected and underreported, and the role of imaging is a critical part of the investigation of abuse (moderate evidence). □ Radiographic skeletal survey is the main diagnostic tool in the diagnosis of skeletal injuries in both living and dead children (moderate evidence). □ Repeat skeletal surveys can clarify and substantiate initially equivocal findings (moderate evidence). □ Skeletal scintigraphy can be used as an adjunct to the skeletal survey (moderate evidence). □ Infant deaths are most likely due to head trauma, whereas toddlers are more likely to die from blunt abdominal trauma (strong evidence).