RESUMO
El papel de la imagen en los casos de sospecha de malos tratos no es solo identificar el grado de lesiones físicas, sino también valorar todos los hallazgos de imagen que apunten hacia diagnósticos alternativos. Se hace preciso pruebas clarificadoras que nos lleve a un diagnóstico seguro y evite por un lado errores diagnósticos y por otro mantener una situación de riesgo de nuevos episodios de maltrato de consecuencias impredecibles. La actual oferta tecnológica del diagnóstico por imagen, exige al clínico que se enfrenta a un diagnóstico de sospecha de maltrato físico, conocer cuales son las lesiones más especificas de confirmación diagnóstica, así como cual es la técnica/as más indicada de acuerdo a la clínica y edad del paciente. Revisamos las recomendaciones actuales partiendo de nuestra experiencia
The image technology develops an important role in cases of abuse suspicion not only establishing the degree of physical harm, but also finding evidences that lead to different diagnosis. These verified evidences are required both to reach a certain diagnosis and to avoid mistakes which can perpetuate a risk situation and the arrival of new episodes of abuse with unpredictable consequences. The present situation in the image technology diagnosis demands from the physician the identification of the most specific lesions to confirm a suspicion of abuse as well as the most suitable technology according to the symptoms and age of the patient. We review the current recommendations from our experience
Assuntos
Masculino , Feminino , Criança , Humanos , Maus-Tratos Infantis/diagnóstico , Ferimentos e Lesões , Violência Doméstica , Diagnóstico por Imagem/métodos , Espectroscopia de Ressonância Magnética , Síndrome de Munchausen , Fraturas ÓsseasRESUMO
During last years bone scanning has shown a great accuracy in the diagnosis of primitive bone tumors and bone metastasis in adult patients. With the use of short lived tracers this technique has also been used in Pediatrics. The authors present their experience in the evaluation of bone scanning in 31 patients with different tumoral processes doing a correlation between scanning, radiological images and clinical findings. The technique is presented for discussion showing its possibilities, limitations and future of its application in Pediatrics.
