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The role of the follow-up chest radiograph in suspected non-accidental injury.

Anilkumar A, Fender LJ, Broderick NJ, Somers JM, Halliday KE

Department of Radiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Derby Road, Nottingham NG7 2UH, UK.

BACKGROUND: Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. OBJECTIVE: To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. MATERIALS AND METHODS: The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. RESULTS: Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. CONCLUSIONS: The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children.

Published 14 February 2006 in Pediatr Radiol, 36(3): 216-8.
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