Dr. Alan E. Oestreich, Emeritus Professor of Radiology and Pediatrics at the University of Cincinnati and Emeritus Radiologist at Cincinnati Children’s, and Dr. Marguerite M. Caré, Assistant Professor at the University of Cincinnati and an attending pediatric neuroradiologist at Cincinnati Children’s, have written a book entitled Recognizing Child Abuse in Radiology. The book is directed not only to fellow radiologists, but also to others who are involved in treating children who have been abused. The book aids with helping to understand features that might suggest a child has been abused; it also provides guidance to help with conditions or diseases that might mistakenly be considered or mimic abuse.
There is a twofold purpose to the book. First, it covers what findings the radiologist may see on imaging that can identify an injury resulting from abuse. A radiologist’s first obligation is not to miss something that could mean abuse or child battering has occurred. The second purpose is recognizing those things that simulate or look like child abuse on imaging, but are actually due to other causes. The book centers on these conditions that might mimic abusive injuries because it is important that they should not be confused with real abuse, leading to a false accusation or a child being wrongly removed from a family or caretaker. Sometimes, this interpretation and the ability to distinguish abuse is not easily made by the imaging alone.
Image: The arrowheads point to a short straight margin of the bones of the forearm at the wrist. These are a normal “metaphyseal collar” of those bones. The change of contour to the adjacent curved bone is NORMAL, and should not be mistaken for fracture.
Dr. Oestreich’s contribution to the book centers on the skeleton and other parts of the body while Dr. Caré’s contribution centers on the brain, head and the spine. The book contains numerous examples of various radiologic images such as x-rays, CT, MRI and others, which can diagnose or rule out the diagnosis of abuse.
Image: Complex skull fractures in a 9-week old abused infant. 3-dimensional reconstruction of the posterior skull demonstrates complex fractures involving both parietal bones, more widened on the right (arrow). There is also extension into the left occipital bone (arrowhead).
Dr. Oestreich’s career at Cincinnati Children’s spans nearly 37 years. He received his MD from Johns Hopkins University School of Medicine. Currently, he plays a key role in education in the department with much of his time spent teaching the medical students that rotate through radiology. His special areas of interest include orthopaedic radiology, metabolic bone disease, dysplasias, conventional pediatric radiology, perception, as well as mathematical applications in radiology. He has written several articles and books that are published in his field of study, including The Journal of the American Medical Association, Pediatric Radiology, Skeletal Radiology, and Radiographics.
Dr. Caré received her MD from Creighton University, in Omaha, NE. Her area of interest and expertise is in the neuroimaging of child abuse. Just like Dr. Oestreich, she has written numerous articles that have been published in her field of study.