Radiology Residents Often Miss Child Abuse

Many radiology residents do not accurately recognize child abuse, according to a study presented at the annual meeting of the American Roentgen Ray Society, held from May 5 to 10 in Honolulu.

Priya Sharma, M.D., from the University of Florida in Gainesville, and colleagues examined residents' ability to accurately recognize and report child abuse using the Emergent/Critical Care Imaging Simulation of an emergency imaging experience. One of these cases required the resident to accurately identify skeletal and/or cross-sectional imaging findings of nonaccidental trauma; 1,002 radiology residents were given this case over five years.

The researchers found that radiology residents consistently undercalled the diagnosis of child abuse. From 2014 to 2018, the average correctly called score was 39.2 percent. Sixty-one percent of residents correctly called nonaccidental trauma in year 1 compared with 20 percent in year 2 and 81 percent in year 3. In year 4, only 1 percent of the residents correctly diagnosed nonaccidental trauma when provided with a history of cyanosis and given a chest X-ray with multiple posterior rib fractures. In year 5 of testing, 33 percent correctly diagnosed the case when given a magnetic resonance image of abusive head trauma. The correct call rate was higher for cases with leading histories.

"With the increasing rates of child abuse reported year over year, the observation and interpretation of the imaging findings associated with child abuse is of the upmost importance," Sharma said in a statement.

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