Radiology Helps Identify Domestic Abuse and Sexual Assault

Common patterns of injury detected by radiologists could help identify victims of intimate partner violence, according to a new study.

Researchers at Brigham and Women’s Hospital (BWH; Boston, MA, USA) conducted a study of the electronic medical record (EMR) of 87 patients (mean age 34.7 years) referred to domestic abuse and sexual assault programs from January to October 2016. The vast majority (95%) of the patients were female, and 40% were African-American. In all, 665 radiology exams were performed in the study population over five years, with the most common exam being a chest X-ray, followed by head computerized tomography (CT), pelvic ultrasound, and musculoskeletal X-rays.

The results revealed that 109 radiology exams were performed in victims of domestic abuse and sexual assault over the five-year period. Sexual assault victims were younger (mean age 27.3 years) and the majority were female (91%) and African-American (46%). Intimate partner violence victims were more likely to be homeless, while sexual assault victims were more likely to suffer from illicit drug abuse. The study was presented at the annual meeting of the Radiological Society of North America (RSNA), held during November 2017 in Chicago (IL, USA).

"On the radiologic front, we identified common patterns of injury such as soft tissue injuries and extremity fractures, which often involved the distal upper extremities, suggesting injury from defensive attempts,” said lead author Elizabeth George, MD. “Other commonly seen injuries were facial fractures, which represent an easily accessible area for inflicting trauma. These injury patterns could alert the radiologists to potential intimate partner violence.”

“In the emergency room setting, the priority is to identify acute pathologies. As a result, old fractures or fracture-related deformities may not be given sufficient importance. But the presence of old and acute fractures may be pivotal in making the diagnosis of intimate partner violence,” added study co-author Bharti Khurana, MD. “Our findings point toward the complex nature of these social situations and the need for a targeted intervention program not only to identify but also intervene in the various aspects of care of these patients.”

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