Effectiveness of low dose computed tomography to detect fractures in paediatric suspected physical abuse: a systematic review.
Int J Legal Med
; 138(5): 1857-1866, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38619573
ABSTRACT
PURPOSE:
The skeletal survey X-ray series is the current 'gold standard' when investigating suspected physical abuse (SPA) of children, in addition to a non-contrast computed tomography (CT) brain scan. This systematic literature review synthesised findings of published research to determine if low dose computed tomography (LDCT) could detect subtle fractures and therefore replace the skeletal survey X-ray series in the investigation of SPA in children aged under 3 years.METHODS:
Five electronic databases and grey literature were systematically searched from their inception to 28 April 2022. Primary studies were included where the population comprised paediatric patients up to 16 years and LDCT was used to detect fractures associated with SPA. Studies involving imaging investigations of the head, standard dose CT examinations or accidental trauma were excluded.RESULTS:
Three studies met the inclusion criteria, all of which were case series. These studies did not report many of the criteria required to compare the accuracy of LDCT to X-ray, i.e. they did not meet the criteria for a diagnostic accuracy test. Therefore, it is difficult to conclude from the case series if LDCT is accurate enough to replace X-rays.CONCLUSION:
Due to the gap in current literature, a phantom study and subsequent post-mortem CT study are recommended as the primary investigative methods to assess the ability of low-dose CT to identify the subtle fractures associated with SPA and to calculate how low the achievable CT dose can be.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Radiation Dosage
/
Tomography, X-Ray Computed
/
Child Abuse
/
Fractures, Bone
Limits:
Child
/
Child, preschool
/
Humans
/
Infant
Language:
En
Journal:
Int J Legal Med
Journal subject:
JURISPRUDENCIA
Year:
2024
Document type:
Article
Affiliation country:
Australia
Country of publication:
Germany