ArticlePediatric radiology2017
Performance of computed tomography of the head to evaluate for skull fractures in infants with suspected non-accidental trauma.
Article in Pediatric radiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Computed tomography versus radiography for the detection of rib and skull fractures in paediatric suspected physical abuse: a systematic review.European journal of pediatrics · 2024Pooled it
- Evaluation of ultra-low and low-dose CT skeletal survey for fracture detection in assessments for suspected non-accidental injury: a prospective post-mortem study.Skeletal radiology · 2026Article
- Skeletal surveys for suspected infant abuse: patient-specific radiation dose estimation using a hybrid computational phantom.Pediatric radiology · 2025Article
- Advances and Challenges in Traumatic Brain Injury from a Forensic Perspective.Current neuropharmacology · 2025Review
- Abusive head trauma in children: radiographs of the skull do not provide additional information in the diagnosis of skull fracture when multiplanar computed tomography with three-dimensional reconstructions is available.Pediatric radiology · 2022Article
- Sibling screening in suspected abusive head trauma: a proposed guideline.Pediatric radiology · 2021Review
- Utility of three-dimensional and reformatted head computed tomography images in the evaluation of pediatric abusive head trauma.Pediatric radiology · 2021Review
- Skull fractures in abusive head trauma: a single centre experience and review of the literature.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021Review
- Identification of Abusive Head Trauma in High-Risk Infants: A Cost-Effectiveness Analysis.The Journal of pediatrics · 2020Article
- Avoiding skull radiographs in infants with suspected inflicted injury who also undergo head CT: "a no-brainer?"European radiology · 2020Article
- Imaging of non-accidental injury; what is clinical best practice?Journal of medical radiation sciences · 2018Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundYoung children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance.
objectiveTo evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma. MATERIALS AND
methodsThis was a retrospective (2013-2014) cross-sectional study of infants evaluated for abusive head trauma via both skull radiographs and CT with 3-D reconstruction. The reference standard was skull radiography. All studies were read by pediatric radiologists and neuroradiologists, with ten percent read by a second radiologist to evaluate for interobserver reliability.
resultsOne hundred seventy-seven children (47% female; mean/median age: 5 months) were included. Sixty-two (35%) had skull fractures by radiography. CT with 3-D reconstruction was 97% sensitive (95% confidence interval [CI]: 89-100%) and 94% specific (CI: 87-97%) for skull fracture. There was no significant difference between plain radiographs and 3-D CT scan results (P-value = 0.18). Kappa was 1 (P-value <0.001) between radiologist readings of CTs and 0.77 (P = 0.001) for skull radiographs.
conclusionCT with 3-D reconstruction is equivalent to skull radiographs in identifying skull fractures. When a head CT is indicated, skull radiographs add little diagnostic value.
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