Imaging of non-accidental injury

Abstract

The term ‘non-accidental injury’ implies the physical abuse of a child by a person or persons (usually adult) in whose care that child is placed. The vast majority of child abuse and neglect fatalities are less than 5 years old, and a significant number (41%) are less than 1 year old. Skeletal, neurological and organ damage may be present in the absence of clinical signs. The radiologist therefore plays a crucial role in the diagnosis of non-accidental injury. The key imaging modality in suspected cases is plain radiography in the form of a ‘skeletal survey’. Cross-sectional imaging (ultrasound, computed tomography and magnetic resonance imaging) also has a role, particularly in neurological assessment and exclusion of visceral injury. Radioisotope imaging is less commonly employed.