By: Lewis First, MD, MS; Editor-in-Chief
Sadly no—at least as per the study results reported by Wood et al. (doi: 10.1542/peds.2014-3977) in a retrospective study of more than 2500 abused children from more than 350 hospitals released this week in our journal. The authors looked at inter-hospital variations and identified a variety of factors at the child and hospital level that influence the probability that occult fractures are or are not sought after.
For example, a smaller hospital with less young injured patients may be less apt to think about checking for occult fractures than one that is larger and sadly sees more of these patients. The bottom line is that many injured children as a result of abuse and non-accidental injury are not being evaluated for occult fractures despite the importance of doing so.
How important is this? Dr. Kristine Campbell, a specialist in the prevention of child abuse and neglect further comments on the ramifications of what this study suggests in an accompanying commentary (doi: 10.1542/peds.2015-0694).Hopefully forgetting to think about and in turn diagnose occult fractures does not happen in your local emergency room or in your practice when patients with alleged abuse are being evaluated –and if for some reason, you need a reminder to get a skeletal survey, this study and commentary should provide the painful reminder you need.
- Critical Elements in the Medical Evaluation of Suspected Child Physical Abuse
- Variation in Occult Injury Screening for Children With Suspected Abuse in Selected US Children’s Hospitals