Whole-Body MRI Helps Identify Suspected Child Abuse

The diagnosis of abuse relies greatly on the presence of skeletal injuries, and high-quality skeletal surveys (a series of X-rays of all the bones in the body) are recommended to visualize the frequently subtle high-specificity fractures seen in infant abuse. Bruises are the most typical sign of physical abuse, but subcutaneous tissue and muscle injuries are not currently assessed with a global imaging technique in living children.

The study, performed at Children's Hospital Boston (MA, USA) and Harvard Medical School (Boston, MA, USA), included 21 infants who underwent whole-body MRI for the evaluation of suspected child abuse. Summary skeletal survey and whole-body MRI identified 167 fractures or areas of skeletal signal abnormality.

"Although our study results revealed that whole-body MRI is insensitive in the detection of classic metaphyseal lesions and rib fractures, we found it did identify soft-tissue injuries such as muscle edema and joint effusions that, in some cases, led to identifying additional fractures,” said Jeannette M. Perez-Rossello, M.D., lead author of the study, which was published in the September 2010 issue of the American Journal of Roentgenology (AJR). "Although our study indicates that whole-body MRI is currently unsuitable as a primary global skeletal imaging tool for suspected abuse, it may be useful as a supplement to the skeletal survey in selected cases, particularly with regard to soft tissue injuries.”

Related Links:
Children's Hospital Boston
Harvard Medical School