Why are CT scans used to evaluate children for injuries secondary to child abuse?
Computed tomography (CT) imaging is a very useful test for evaluating the skull and facial bones for fractures and the chest and abdomen for bone and soft tissue (organ) injuries. CT of the head without contrast may be ordered to evaluate for suspected head trauma in children. CT is useful to identify blunt trauma injuries to the chest, intestines, spleen and liver. CT imaging is a quick diagnostic tool. Drawbacks include missed small hemorrhages, hemotomas or fractures.
CT of the head should be utilized when the mechanism of injury may correlate with occult head injury and when physical examination indicates suspicion for head trauma. CT scans are often repeated to evaluate for evolving injury and infarction.
The American College of Radiology (ACR) recommends that children with neurological symptoms associated with suspected child abuse undergo CT evaluation. In children younger than two years of age, CT is recommended (by ACR) for children suspected to be victims of child abuse that have no focal or neurological signs and symptoms.