RSS-Feed abonnieren
DOI: 10.1055/a-1019-8018
The German Evidence-Based Child Protection Guideline – Imaging in Suspected Child Abuse
Artikel in mehreren Sprachen: English | deutschPublikationsverlauf
31. Juli 2019
13. September 2019
Publikationsdatum:
20. November 2019 (online)
Abstract
Aim Development of a fully evidence-based guideline including all aspects of child abuse.
Methods In a case-based procedure, 144 primary PICO questions were generated from 476 presented cases of child abuse. Literature research was performed in 5 databases (Pubmed, CINHAL, Embase, PsycInfo, Eric) and in the Cochrane Library. The literature was evaluated according to SIGN and AGREE II.
Results 137 recommendations were developed. Those related to imaging procedures are presented and discussed in this article.
Conclusion The first fully evidence-based German guideline concerning all aspects of child abuse has been established. For imaging, several relevant new approaches have been proposed.
Key Points:
-
The average radiation exposure is significantly reduced for the whole group of examined children.
-
The pelvic view and lateral spine are no longer basic views of the skeletal survey but are only performed additionally in the case of a positive survey.
-
Oblique views and a follow-up survey are performed in the case of a negative skeletal survey and ongoing suspicion of child abuse.
Citation Format
-
Born M, Schwier F, Stoever B et al. The German Evidence-Based Child Protection Guideline – Imaging in Suspected Child Abuse. Fortschr Röntgenstr 2020; 192: 343 – 348
-
References
- 1 Polizeiliche Kriminalstatistik, 2.4.2019. Bundesrepublik Deutschland Jahrbuch 2018; Band 2 – Opfer; 66. Ausgabe, V 1.0. Im Internet: https://www.bka.de/DE/AktuelleInformationen/StatistikenLagebilder/PolizeilicheKriminalstatistik/PKS2018 / pks2018_node.html;jsessionid=F145661BECE06BA633877F0E8AF760F9.live2291 (“Datenlizenz Deutschland – Namensnennung – Version 2.0”, Lizenztext unter www.govdata.de/dl-de/by-2-0); Stand 15.7.2019
- 2 Deutsche Gesellschaft für Kinderschutz in der Medizin (DGKiM). Im Internet: www.kinderschutzleitlinie.de ; Stand: 15.7.2019
- 3 University of Illinois at Chicago’s Library of the Health Sciences at Peoria. Im Internet: https://researchguides.uic.edu/ebm ; Stand 15.7.2019
- 4 Guidelines in Praxis. Im Internet: https://www.guidelinesinpractice.co.uk/the-scottish-intercollegiate-guidelines-network-sign-/305547.article ; Stand 15.7.2019
- 5 Browers MC, Kho ME, Browman GP. et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ 2010; 182 (18) E839-E842 . doi:10.1503/cmaj.090449
- 6 American College of Radiology. ACR-SPR practice guideline for skeletal surveys in children. 2011. Im Internet: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Skeletal-Survey.pdf ; Stand 15.7.2019
- 7 The Royal College of Radiologists, the Royal College of Paediatrics and Child Health. Standards for radiological investigations of suspected non-accidental injury. London: RCR and RCPCH; 2017 Im Internet: https://www.rcr.ac.uk/publication/radiological-investigation-suspected-physical-abuse-children ; Stand 15.7.2019
- 8 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF). S1-Leitlinie 064/014 -Verdacht auf Misshandlung -Bildgebende Diagnostik. Im Internt: https://www.awmf.org/leitlinien/detail/ll/027-069/ll-ansicht/inhalt.html ; Stand 15.7.2019
- 9 Phillips KL, Bastin ST, Davies-Payne D. et al. Radiographic skeletal survey for non-accidental injury: systematic review and development of a national New Zealand protocol. J Med Imaging Radiat Oncol 2015; 59: 54-65 . doi:10.1111/1754-9485.12271
- 10 https://www.awmf.org/uploads/tx_szleitlinien/027-069m_S3_Kindesmisshandlung-missbrauch-vernachlaessigung-Kinderschutzleitlinie_2019-02.pdf
- 11 Royal College of Paediatrics and Child Health 2017. Child Protection Evidence Systematic review on Neurological Injuries. Cardiff University. Im Internt: https://www.rcpch.ac.uk/sites/default/files/2018-07/child_protection_evidence_-_neurological_injuries.pdf ; Stand 15.7.2019
- 12 Lindberg DM, Berger RP, Reynolds MS. et al. Yield of Skeletal Survey by Age in Children Referred to Abuse Specialists. J Pediatr 2014; 164: 1268-1273 . doi:10.1016/j.jpeds.2014.01.068
- 13 Maguire S, Cowley L, Mann M. et al. What does the recent literature add to the identification and investigation of fractures in child abuse: an overview of review updates 2005–2013. Evid-Based Child Health 2013; 8: 2044-2057 . https://doi.org/10.1002/ebch.1941
- 14 Royal College of Paediatrics and Child Health 2017. Child Protection Evidence Systematic review on Fractures Last updated: February 2015. Im Internet: https://www.rcpch.ac.uk/resources/child-protection-evidence-fractures ; Stand 15.7.2019
- 15 Lindberg DM, Shapiro RA, Laskey AL. et al. Prevalence of abusive injuries in siblings and household contacts of physically abused children. Pediatrics 2012; 130: 193-201 . doi:10.1542/peds.2012-0085
- 16 Perez-Rossello JM, Connolly SA, Newton AW. et al. Whole-body MRI in suspected infant abuse. Am J Roentgenol 2010; 195: 744-750 . doi:10.2214/Am J Roentgenol.09.3364
- 17 Darge K, Jaramillo D, Siegel MJ. Whole-body MRI in children: Current status and future applications. EJR 2008; 68: 289-298 . doi:10.1016/j.ejrad.2008.05.018
- 18 Jha P, Stein-Wexler R, Coulter K. et al. Optimizing bone surveys performed for suspected non-accidental trauma with attention to maximizing diagnostic yield while minimizing radiation exposure: utility of pelvic and lateral radiographs. Pediatr Radiol 2013; 43: 668-672 . doi:10.1007/s00247-012-2614-9
- 19 Karmazyn B, Lewis ME, Jennings SG. et al. The prevalence of uncommon fractures on skeletal surveys performed to evaluate for suspected abuse in 930 children: should practice guidelines change?. Am J Roentgenol 2011; 197: W159-W163 . doi:10.2214/Am J Roentgenol.10.5733
- 20 Kleinman PK, Morris NB, Makris J. et al. Yield of radiographic skeletal surveys for detection of hand, foot, and spine fractures in suspected child abuse. Am J Roentgenol 2013; 200: 641-644 . doi:10.2214/Am J Roentgenol.12.8878
- 21 Powell-Doherty RD, Raynor NE, Goodenow DA. et al. Examining the role of follow-up skeletal surveys in non-accidental trauma. Am J Surg 2017; 213: 606-610 . doi:10.1016/j.amjsurg.2016.12.004
- 22 Harper NS, Eddleman S, Lindberg DM. et al. The utility of follow-up skeletal surveys in child abuse. Pediatrics 2013; 131: e672-e678 . doi:10.1542/peds.2012-2608
- 23 Harper NS, Lewis T, Eddleman S. et al. Follow-up skeletal survey use by child abuse pediatricians. Child Abuse Negl 2016; 51: 336-342 . doi:10.1016/j.chiabu.2015.08.015
- 24 Karmazyn B, Wanner MR, Marine MB. et al. The added value of a second read by pediatric radiologists for outside skeletal surveys. Pediatr Radiol 2019; 49: 203-209 . doi:10.1007/s00247-018-4276-8