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Final ID: Poster #: EDU-031

A Multidisciplinary Approach to the Evaluation of Sentinel Injuries in Infants with Suspected Abuse: Definition, Indications for Imaging, and Future Directions

Purpose or Case Report: Infants are at risk for fatal physical abuse yet may present to care multiple times with inflicted trauma before abuse is diagnosed and the infant is protected. Prompt identification of at-risk infants is essential to protection from ongoing abuse. Sentinel injuries are unexplained minor injuries in young infants that are appreciable on physical exam. Examples of sentinel injuries include bruising, subconjunctival hemorrhages, and intra-oral trauma. These injuries can be a subtle external sign of concurrent clinically occult internal injuries (e.g., skeletal, abdominal, intracranial injuries) in a well-appearing infant or may be an early warning that foretells more significant trauma in the future. Identification and evaluation of these infants with appropriate imaging has been highlighted as one approach to ensure that abuse is promptly detected, injuries are addressed, and the infant is protected.

In this multidisciplinary educational presentation made in collaboration with child abuse pediatricians and pediatric radiologists, we will: (1) review different types of sentinel injuries; (2) discuss current evidence and guidance for performance of imaging (skeletal survey, abdominal CT, neuroimaging with MRI or CT) when a sentinel injury is identified; (3) discuss the interpretation and significance of imaging findings; (4) provide imaging examples of these injuries; and (5) discuss gaps in the literature while highlighting opportunities for collaboration between child abuse pediatricians and pediatric radiologists to improve the care of these infants.

Following completion of this educational module, our goals are that the participant will better understand the clinical context of sentinel injuries and have a baseline knowledge to make an appropriate imaging plan for these infants.
Methods & Materials:
Results:
Conclusions:
  • Henry, M Katherine  ( The Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • White, Ammie  ( The Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Servaes, Sabah  ( West Virginia University Children’s Hospital , Morgantown , West Virginia , United States )
  • Wood, Joanne  ( The Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
Session Info:

Posters - Educational

Informatics, Education, QI, or Healthcare Policy

SPR Posters - Educational

More abstracts on this topic:
How Well do Hospitals Comply with ACR-SPR Guidelines when Performing Skeletal Surveys for Child Abuse?

Marine Megan, Smith Jessica, Wanner Matthew, Jennings Samuel, Hibbard Roberta, Karmazyn Boaz

How to Differentiate between Normal Variants and Child Abuse on Skeletal Survey

Hwang Misun, Servaes Sabah

More abstracts from these authors:
Recruitment in Pediatric Radiology: Strategizing for Success

Servaes Sabah

Enchondroma Protuberans of the Right Index Finger

Farhat Ahmed, Huang Pauline, Servaes Sabah, Hailemichael Eyassu

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