未经评估:身体虐待是儿童长期发病和死亡的常见但可预防的原因。尽管索引儿童中的虐待与接触儿童中的虐待之间存在很强的联系,没有概述如何筛选后者的指导,更脆弱的群体,虐待伤害。因此,经常省略对接触儿童的放射学评估,或可变地执行,允许隐匿性损伤未被发现,并增加进一步滥用的风险。
UNASSIGNED:报告一套基于证据和共识的最佳做法,用于在疑似儿童身体虐待的情况下对接触儿童进行放射筛查。
UNASSIGNED:这一共识声明得到了对文献的系统回顾和国际公认的26名专家组的临床意见的支持。修改后的德尔菲共识进程包括2021年2月至6月间举行的关于可疑儿童身体虐待接触筛查国际共识小组的3次会议。
未经评估:联系人被定义为无症状兄弟姐妹,同居的孩子,或与怀疑儿童身体虐待的索引儿童受到相同照顾的儿童。所有接触儿童应在成像前进行彻底的体检和病史。接触不到12个月的儿童应该有神经影像学检查,首选的模态是磁共振成像,和骨骼调查。12至24个月的接触儿童应进行骨骼检查。24个月以上的无症状儿童未进行常规影像学检查。如果演示时异常或模棱两可,应进行视野有限的后续骨骼调查。具有阳性结果的联系人应作为索引儿童进行调查。
UNASSIGNED:本特别通讯报告了在涉嫌儿童身体虐待的情况下对接触儿童进行放射筛查的共识建议。为这些高危儿童的严格评估建立公认的基线,并为临床医生提供一个更有弹性的平台来倡导他们。
Physical abuse is a common but preventable cause of long-term childhood morbidity and mortality. Despite the strong association between abuse in an index child and abuse in contact children, there is no guidance outlining how to screen the latter, significantly more vulnerable group, for abusive injuries. Consequently, the radiological assessment of contact children is often omitted, or variably performed, allowing occult injuries to go undetected and increasing the risk of further abuse.
To report an evidence-based and
consensus-derived set of best practices for the radiological screening of contact children in the context of suspected child physical abuse.
This
consensus statement is supported by a systematic review of the literature and the clinical opinion of an internationally recognized group of 26 experts. The modified Delphi
consensus process comprised 3 meetings of the International
Consensus Group on Contact Screening in Suspected Child Physical Abuse held between February and June 2021.
Contacts are defined as the asymptomatic siblings, cohabiting children, or children under the same care as an index child with suspected child physical abuse. All contact children should undergo a thorough physical examination and a history elicited prior to imaging. Contact children younger than 12 months should have neuroimaging, the preferred modality for which is magnetic resonance imaging, and skeletal survey. Contact children aged 12 to 24 months should undergo skeletal survey. No routine imaging is indicated in asymptomatic children older than 24 months. Follow-up skeletal survey with limited views should be performed if abnormal or equivocal at presentation. Contacts with positive findings should be investigated as an index child.
This Special Communication reports
consensus recommendations for the radiological screening of contact children in the context of suspected child physical abuse, establishing a recognized baseline for the stringent evaluation of these at-risk children and providing clinicians with a more resilient platform from which to advocate for them.