Guidelines for skeletal surveys in suspected child abuse

Introduction Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misdiagnosis are serious. Should head trauma or fractures be overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. Conversely, where no abuse has taken place, but the certainty of the diagnosis is questionable, the unnecessary hospitalization of an innocent family may result. In Southern Denmark approximately 15-20 children per year are examined. The examinations are performed in four different radiology departments throughout the region. Until the autumn of 2012, a variety of imaging protocols and techniques were used in pediatric skeletal surveys. This led to difficulties, because some cases are subject to second opinion report. In many cases, supplemental images or a complete reexamination of the child was required in order to facilitate a second opinion, resulting in unnecessary exposure. Methods An initial consensus meeting with 20 participants was arranged in 2012. Pediatric radiologists, managers and radiographers with special competencies in pediatric radiology attended. Research evidence, cases and clinical experience was discussed. A follow-up meeting was arranged in 2013 with similar participants. This second meeting focused mainly on follow-up skeletal surveys in children <2 years of age Results The first meeting resulted in the agreement on which projections to acquire, image quality criteria, how to cooperate with the parents, radiologic evaluation criteria and the role of the radiographer in imaging the abused child. The second meeting resulted in consensus on the necessary projections required for follow-up skeletal surveys. Conclusion Common protocols for child abuse imaging have been established and fully implemented in the Region of Southern Denmark. Annual meetings have also been established where legal aspects, best practice and best evidence in imaging and cooperation with pediatric departments is discussed

Facilitators for and barriers to radiography research in public healthcare in Nordic countries

Introduction: It has been suggested that the future of diagnostic imaging relies on engagement in research and evidence-based practice. This implies a role transition from a clinical radiographer to a clinical radiographer-researcher. Clinical radiographers’ stimuli for engaging in research in Nordic countries are unknown. This study aimed to address this gap.Methods: Cross-sectional data collection via an online questionnaire on facilitators for and barriers to participation in radiography research was carried out among 507 clinical radiographers in public healthcare in the Nordic countries: Denmark, Finland, Norway and Sweden.Results: Support from colleagues (odds ratio [OR] 2.62) and other professionals (OR 2.74), and self-esteem in research skills (OR ≥ 2.21), were facilitators for radiography research. Lack of knowledge and skills to conduct research (OR 2.48) was revealed to hinder radiographers’ participation in research. The absence of a radiography research culture in the workplace explained non-participation in research (OR 1.75).Conclusion: This study revealed significant factors for clinical radiographers’ participation in research.Implications for practice: A strategy for establishing a radiography research culture in healthcare is proposed that is novel for the context. Management support for knowledge development and activity leading to inter-professional research projects across knowledge fields, provision of a radiography research lead and acknowledgement of radiography research among colleagues signify the establishment of the culture. These prerequisites might provide a paradigm change towards not only the symbiosis of a clinical radiographer and an autonomous researcher but also a partner who adds radiography research to evidence-based practice in diagnostic imaging.</p

Guidelines for skeletal surveys in suspected child abuse

Introduction Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misdiagnosis are serious. Should head trauma or fractures be overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. Conversely, where no abuse has taken place, but the certainty of the diagnosis is questionable, the unnecessary hospitalization of an innocent family may result. In Southern Denmark approximately 15-20 children per year are examined. The examinations are performed in four different radiology departments throughout the region. Until the autumn of 2012, a variety of imaging protocols and techniques were used in pediatric skeletal surveys. This led to difficulties, because some cases are subject to second opinion report. In many cases, supplemental images or a complete reexamination of the child was required in order to facilitate a second opinion, resulting in unnecessary exposure. Methods An initial consensus meeting with 20 participants was arranged in 2012. Pediatric radiologists, managers and radiographers with special competencies in pediatric radiology attended. Research evidence, cases and clinical experience was discussed. A follow-up meeting was arranged in 2013 with similar participants. This second meeting focused mainly on follow-up skeletal surveys in children &lt;2 years of age Results The first meeting resulted in the agreement on which projections to acquire, image quality criteria, how to cooperate with the parents, radiologic evaluation criteria and the role of the radiographer in imaging the abused child. The second meeting resulted in consensus on the necessary projections required for follow-up skeletal surveys. Conclusion Common protocols for child abuse imaging have been established and fully implemented in the Region of Southern Denmark. Annual meetings have also been established where legal aspects, best practice and best evidence in imaging and cooperation with pediatric departments is discussed.Introduction Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misdiagnosis are serious. Should head trauma or fractures be overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. Conversely, where no abuse has taken place, but the certainty of the diagnosis is questionable, the unnecessary hospitalization of an innocent family may result. In Southern Denmark approximately 15-20 children per year are examined. The examinations are performed in four different radiology departments throughout the region. Until the autumn of 2012, a variety of imaging protocols and techniques were used in pediatric skeletal surveys. This led to difficulties, because some cases are subject to second opinion report. In many cases, supplemental images or a complete reexamination of the child was required in order to facilitate a second opinion, resulting in unnecessary exposure. Methods An initial consensus meeting with 20 participants was arranged in 2012. Pediatric radiologists, managers and radiographers with special competencies in pediatric radiology attended. Research evidence, cases and clinical experience was discussed. A follow-up meeting was arranged in 2013 with similar participants. This second meeting focused mainly on follow-up skeletal surveys in children &lt;2 years of age Results The first meeting resulted in the agreement on which projections to acquire, image quality criteria, how to cooperate with the parents, radiologic evaluation criteria and the role of the radiographer in imaging the abused child. The second meeting resulted in consensus on the necessary projections required for follow-up skeletal surveys. Conclusion Common protocols for child abuse imaging have been established and fully implemented in the Region of Southern Denmark. Annual meetings have also been established where legal aspects, best practice and best evidence in imaging and cooperation with pediatric departments is discussed

Guidelines for skeletal surveys in suspected child abuse

Introduction Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misdiagnosis are serious. Should head trauma or fractures be overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. Conversely, where no abuse has taken place, but the certainty of the diagnosis is questionable, the unnecessary hospitalization of an innocent family may result. In Southern Denmark approximately 15-20 children per year are examined. The examinations are performed in four different radiology departments throughout the region. Until the autumn of 2012, a variety of imaging protocols and techniques were used in pediatric skeletal surveys. This led to difficulties, because some cases are subject to second opinion report. In many cases, supplemental images or a complete reexamination of the child was required in order to facilitate a second opinion, resulting in unnecessary exposure. Methods An initial consensus meeting with 20 participants was arranged in 2012. Pediatric radiologists, managers and radiographers with special competencies in pediatric radiology attended. Research evidence, cases and clinical experience was discussed. A follow-up meeting was arranged in 2013 with similar participants. This second meeting focused mainly on follow-up skeletal surveys in children &lt;2 years of age Results The first meeting resulted in the agreement on which projections to acquire, image quality criteria, how to cooperate with the parents, radiologic evaluation criteria and the role of the radiographer in imaging the abused child. The second meeting resulted in consensus on the necessary projections required for follow-up skeletal surveys. Conclusion Common protocols for child abuse imaging have been established and fully implemented in the Region of Southern Denmark. Annual meetings have also been established where legal aspects, best practice and best evidence in imaging and cooperation with pediatric departments is discussed.Introduction Child abuse imaging differs from general musculoskeletal imaging in that there is exceptional necessity for high quality images. The images are directly involved in legal processes and the child and the family faces major consequences if imaging is sub-optimal. The consequences of misdiagnosis are serious. Should head trauma or fractures be overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. Conversely, where no abuse has taken place, but the certainty of the diagnosis is questionable, the unnecessary hospitalization of an innocent family may result. In Southern Denmark approximately 15-20 children per year are examined. The examinations are performed in four different radiology departments throughout the region. Until the autumn of 2012, a variety of imaging protocols and techniques were used in pediatric skeletal surveys. This led to difficulties, because some cases are subject to second opinion report. In many cases, supplemental images or a complete reexamination of the child was required in order to facilitate a second opinion, resulting in unnecessary exposure. Methods An initial consensus meeting with 20 participants was arranged in 2012. Pediatric radiologists, managers and radiographers with special competencies in pediatric radiology attended. Research evidence, cases and clinical experience was discussed. A follow-up meeting was arranged in 2013 with similar participants. This second meeting focused mainly on follow-up skeletal surveys in children &lt;2 years of age Results The first meeting resulted in the agreement on which projections to acquire, image quality criteria, how to cooperate with the parents, radiologic evaluation criteria and the role of the radiographer in imaging the abused child. The second meeting resulted in consensus on the necessary projections required for follow-up skeletal surveys. Conclusion Common protocols for child abuse imaging have been established and fully implemented in the Region of Southern Denmark. Annual meetings have also been established where legal aspects, best practice and best evidence in imaging and cooperation with pediatric departments is discussed