While we suspect that abuse to siblings and other household contacts of those who have been physically abused might be common, the evidence has not been strong to date. Lindberg et al. (
doi: 10.1542/peds.2012-0085) performed an observational cross-sectional study of children and their siblings and other close contacts that involved 20 U.S. child abuse teams working from a common screening protocol. The results are troubling to say the least, with unsuspected fractures being found in contacts of more than 10% of the index cases studied. Although this represents only 134 contacts, the findings may encourage you to strongly consider imaging other children in the home where a child has been physically abused. Don not neglect this study given how it may change your approach to working up siblings and other contacts in an abusive environment.
