Radiology : Radiologic Evaluation of Siblings and Other Contact Children
Contact Children Include
- Siblings who are in the same household
- Children under the same care as the index children
- Other children who live with or are related to the suspected perpetrator of abuse
When a child suspected of being physically abused is evaluated by the medical provider, a thorough history should include questions regarding the existence of potential contact children. All these children should receive a thorough examination. This examination may be performed by the primary care physician or a child abuse pediatrician or Advance Practice Provider. The examination may identify bruising or other injuries that need further work-up, including possibly radiological imaging.
Per the International Consensus Statement on the Radiological Screening of Contact Children in the Context of Suspected Child Physical Abuse, a Special Communication of JAMA Pediatrics (Mankad K et al 2023), all children should receive a thorough physical examination prior to the imaging.
Evaluation Modalities for Contact Children
- Infants <12-months should have neuroimaging (MRI is preferred) and a skeletal survey
- Infants 12-24 months should be evaluated with a skeletal survey
- Infants >24 months, no routine imaging is recommended for screening
When skeletal surveys are obtained, a follow-up skeletal survey may be indicated on a case-by-case basis, particularly for follow-up of equivocal findings on the initial skeletal survey.
If suspicious physical or Xray findings are identified in the contact children, they should be treated as if they are index children, and their contacts should also be investigated.
