Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants

Sandra L. Wootton-Gorges, Rebecca Stein-Wexler, John W. Walton, Angela J. Rosas, Kevin Coulter, Kristen K. Rogers

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: Chest radiographs (CXR) are the standard method for evaluating rib fractures in abused infants. Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants. Methods: This retrospective study included all 12 abused infants identified from 1999 to 2004 who had rib fractures and both CXR and CT (8 abdomen CTs, 4 chest CTs). CT exams had been performed for clinical indications, and were obtained within one day of the CXR. Studies were reviewed by two pediatric radiologists to determine the number, locations, and approximate ages of the rib fractures. A total of 225 ribs were completely (192) or partially (33) seen by CT, and the matched ribs on CXR were used for the analysis. Results: The mean patient age was 2.5 months (1.2-5.6), with seven females and five males. While 131 fractures were visualized by CT, only 79 were seen by CXR (p < .001). One patient had fractures only seen by CT. There were significantly (p < .05) more early subacute (24 vs. 4), subacute (47 vs. 26), and old fractures (4 vs. 0) seen by CT than by CXR. Anterior (42 vs. 11), anterolateral (21 vs. 12), posterolateral (9 vs. 3) and posterior (39 vs. 24) fractures were better seen by CT than by CXR (p < .01). Bilateral fractures were detected more often by CT (11) than by CXR (6). Conclusions: While this study group is small, these findings suggest that CT is better than CXR in visualizing rib fractures in abused infants.

Original languageEnglish (US)
Pages (from-to)659-663
Number of pages5
JournalChild Abuse and Neglect
Volume32
Issue number6
DOIs
StatePublished - Jun 2008

Fingerprint

Rib Fractures
Radiography
infant
Thorax
Tomography
study group
indication
Ribs
evaluation
Abdomen
Retrospective Studies

Keywords

  • Child abuse
  • Computed tomography
  • Infant
  • Radiology
  • Rib fracture

ASJC Scopus subject areas

  • Sociology and Political Science
  • Law
  • Education
  • Social Psychology
  • Developmental and Educational Psychology
  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health

Cite this

Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants. / Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; Walton, John W.; Rosas, Angela J.; Coulter, Kevin; Rogers, Kristen K.

In: Child Abuse and Neglect, Vol. 32, No. 6, 06.2008, p. 659-663.

Research output: Contribution to journalArticle

Wootton-Gorges, Sandra L. ; Stein-Wexler, Rebecca ; Walton, John W. ; Rosas, Angela J. ; Coulter, Kevin ; Rogers, Kristen K. / Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants. In: Child Abuse and Neglect. 2008 ; Vol. 32, No. 6. pp. 659-663.
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AB - Purpose: Chest radiographs (CXR) are the standard method for evaluating rib fractures in abused infants. Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants. Methods: This retrospective study included all 12 abused infants identified from 1999 to 2004 who had rib fractures and both CXR and CT (8 abdomen CTs, 4 chest CTs). CT exams had been performed for clinical indications, and were obtained within one day of the CXR. Studies were reviewed by two pediatric radiologists to determine the number, locations, and approximate ages of the rib fractures. A total of 225 ribs were completely (192) or partially (33) seen by CT, and the matched ribs on CXR were used for the analysis. Results: The mean patient age was 2.5 months (1.2-5.6), with seven females and five males. While 131 fractures were visualized by CT, only 79 were seen by CXR (p < .001). One patient had fractures only seen by CT. There were significantly (p < .05) more early subacute (24 vs. 4), subacute (47 vs. 26), and old fractures (4 vs. 0) seen by CT than by CXR. Anterior (42 vs. 11), anterolateral (21 vs. 12), posterolateral (9 vs. 3) and posterior (39 vs. 24) fractures were better seen by CT than by CXR (p < .01). Bilateral fractures were detected more often by CT (11) than by CXR (6). Conclusions: While this study group is small, these findings suggest that CT is better than CXR in visualizing rib fractures in abused infants.

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