Assessing the Validity of Mandatory Follow-Up Skeletal Surveys - Essay Example

According to Thompson (2005), physical child cruelty has little or no visible evidence, with pre-verbal children at most risk of being victims with injuries that are frequently at multiple locations, with varying degrees of a healing stage, and in several organ systems. For the duration of infancy, mortality is greater through injury than all other combined causes of opine (Mckinney, Lane, & Hickey, 2004).
Dr. John Caffey's (ref) [this is your citation, not mine …?] identification of unexplained fractures (the mid-1940s) in children who presented to accident and emergency (A+E) departments has led to radiographic technological advances and led to the conceptualization of “the battered child syndrome”. Injuries to the skeleton are important markers in physical child abuse. Fractures with high specificity for maltreatment have been described in many sections of the axial and appendicular skeleton (Kleinman, Marks, Richmond, & Blackbourne, 1995). Identification and dating of skeletal injuries are key factors in alleged child abuse according to Kleinman and colleagues (1995) with the radiographic findings frequently being used in criminal proceedings.
As the incidence of child abuse is of a higher incidence than that of genetic or metabolic bone diseases, differential diagnosis of multiple fractures must have child abuse at the forefront of the investigation. A follow-up skeletal survey provides a way to carefully gather imaging data to reinvestigate old and new fractures that may indicate inflicted trauma (Block, 2005). Several studies attest to the viability of using skeletal survey and follow-up skeletal survey to assess and confirm suspected cases of NAI (Ellerstein & Norris, 1984; Kemp et al., 2006; Nimkin, Spevak, & Kleinman, 1997; Kleinman, Kleinman, & Savage, 2004). The skeletal survey itself is a systematic series of radiographic images that picture the entire skeleton or at least the anatomic areas that are considered appropriate to indicate a clinical condition, as shown in Table 1 (see Appendix A). The skeletal survey aims to identify with precision the focal and diffuse abnormalities that may exist within the skeleton.