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Radiologist Case Studies

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You never know what you might encounter during a work day as a Radiographer. There are many delicate situations in this field. One of those is performing an x –ray on a child who shows signs of suspected abuse. Radiographers can be a child’s first hope of rescue from an abusive parent or guardian. They can spot suspicious signs of child abuse or confirm acts of abuse on these small patients, and hopefully handle each case accordingly.
As a Radiographer, you never know when your normal work day will be affected by a cause much greater than expected. What may initially seem like a routine x-ray may turn in to an unsuspected case of child abuse. These signs should never go unnoticed or dismissed. For example, skin lesions or bruises are the …show more content…

It is also important to determine the age of a bruise by its color. “A bruise that is red in color indicates recent trauma to that area, while a purple, green or brown bruise indicates that it is an older bruise”. Of course, fractures can be a sign of child abuse, but they can also be accidental in nature so a Radiographer has to investigate fractures very closely. “Fractures of child abuse occur most frequently in infants under the age of 3”. The most common fracture that comes from abuse in this age range is rib fractures that occur in the posterior portion. The femur, tibia, and humerus are the most common bones that are usually injured. Some fractures will indicate child abuse more so than others. For example, a spiral fracture entails a twisting force; therefore, it indicates a strong suspicion of child abuse because this motion is not a motion normally seen in the torso area without unusual force. However, physical signs such as lesions and bruises are not the only indication of child abuse. Even if the child shows no signs of physical abuse, they may show signs of emotional abuse. If a child is …show more content…

There are several modalities that can be used to determine if a child has been abused. There are Radiographic Imaging, Computed Tomography, and Magnetic Resonance Imaging. All three of these modalities have different capabilities and depending on the injury of the child, it will determine which modality you would use. If a child of 2 years and younger is suspected to have an injury due to abuse then the Radiographer would use Radiographic imaging and take images of the entire body. Radiographers will take multiple images called a skeletal survey to determine child abuse. A skeletal survey includes more than 20 images. “The ACR (The American College of Radiology) uses these guidelines for a skeletal survey; they must include the thorax, ribs, upper lumbar spine, pelvis, cervical spine, lumbar spine, Humerus, Forearms, hands, Femora, lower legs, and feet. Computed Tomography has over powered the conventional x-rays because of its many advantages”. CT gives 3D images of the injury which would show a rib fracture clearer. Head trauma is the most dangerous form of child abuse and causes that most deaths in children. Head trauma can also cause permanent neurologic damage. Retinal hemorrhage and subdural hemorrhage are thought to be caused by abusive head trauma. Children with head trauma are more likely to have dilated eyes and seizures which will cause an unstable mental status.

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