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Implications for practice

  • We found no evidence to support performing skeletal survey (SS) in siblings of abused children
  • One study performed SS on six siblings, two twinships
    • One, whose twin was fatally abused, had a positive SS with multiple clinical signs of abuse
  • Not enough detail was available to comment on the likely benefit of SS in sexual abuse, neglect or older disabled children
  • Three studies described abusive fractures in older children, one who was disabled and two who had been physically and sexually abused

 

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References

  1. Belfer RA, Klein BL, Orr L. Use of the skeletal survey in the evaluation of child maltreatment. The American Journal of Emergency Medicine. 2001;19(2):122-124 [Pubmed]
  2. Day F, Clegg S, McPhillips M, Mok J. A retrospective case series of skeletal surveys in children with suspected non-accidental injury. Journal of Clinical Forensic Medicine. 2006;13(2):55-59 [Pubmed]
  3. Leventhal JM, Thomas SA, Rosenfield NS, Markowitz RI. Fractures in young children. Distinguishing child abuse from unintentional injuries. American Journal of Diseases of Children. 1993;147(1):87-92 [Pubmed]

 

 

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