Detection of child abuse on computed tomography imaging due to presence of severe caries: A case report

Background: Child abuse can result from physical, verbal, or sexual harm. While child abuse often involves an action that harms the child, inaction, such as neglect, can also cause harm.Case presentation: We present a case in which child abuse was detected through computed tomography imaging findings of severe dental caries. This case was a 5-year-old girl who fell down the stairs and hit her head. The computed tomography of her head showed no abnormalities; however, severe dental caries was detected. The mother’s incomplete history and inadequate explanation of injuries further made us suspect abuse. A whole-body computed tomography was conducted for child abuse screening, which showed an unnatural fracture in the left arm. Through these imaging findings, we were able to identify and help a victim of child abuse.Conclusions: Physicians should be aware that severe dental caries may be a sign of child abuse.

Tactics of Primary Emergency Radiation Diagnosis of Politrauma

The review considers the problem of choosing the optimal tactical approach to primary emergency radiation diagnosis of injuries during polytrauma based on data on indications for use, advantages and disadvantages of modern methods and protocols of radiation imaging. Literary sources were searched in the MedLine/ PubMed and eLibrary databases published from 2009 to 2019.The tactics of selective radiation diagnosis of polytrauma involves performing sequential studies (sonography, X-ray, computed tomography) of body areas in which damage is suspected by the mechanism of injury and clinical data, which limits the accuracy of the diagnosis and increases the duration of the examination. Primary multi-helical “whole-body”computed tomography including head, neck, chest, abdomen and pelvis examination, reduces the percentage of missed injuries, the duration of the examination and the time before emergency surgery, which can significantly reduce mortality in polytrauma. Its use is justified in patients with severe combined trauma if a high level of emergency hospital care organization is provided. Using “whole-body” computed tomography significantly increases the dose and economic costs, but the benefits of it for the survival of patients with polytrauma can outweigh the radiation risk and economic losses. Further development of technologies and protocols for multispiral computed tomography can significantly reduce the dose of radiation and the duration of the study. Clear and well-founded criteria for the selection of patients are needed for whom the use of “whole-body” computed tomography will be an effective strategy for radiation diagnosis.