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What’s in a name? Sentinel injuries in abused infants

  • Child abuse imaging
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Pediatric Radiology Aims and scope Submit manuscript

Abstract

Infants are at greatest risk of severe and fatal physical abuse yet they sometimes present for medical care multiple times with abusive injuries prior to being diagnosed with abuse and having protective actions taken. Efforts to identify these infants in a timely manner are critical to prevent repeated, escalating abuse and subsequent harm. Increasing the identification and evaluation of sentinel injuries has been highlighted as a strategy for improving timely detection of abuse in infants. Sentinel injuries are visible, minor, poorly explained injuries in young infants that raise concern for abuse. These injuries include cutaneous injuries such as bruising, subconjunctival hemorrhages and intra-oral injuries. Sentinel injuries can signal concurrent clinically occult but more serious injuries or precede more significant trauma from abuse. As such, sentinel injuries offer an opportunity to intervene and protect infants from further harm. A thorough physical exam is critical for detecting sentinel injuries. Imaging with skeletal survey and, when appropriate, neuroimaging are key components of the medical evaluation of sentinel injuries in these high-risk infants.

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Authors and Affiliations

  1. Safe Place: The Center for Child Protection and Health, Division of General Pediatrics, Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA

    M. Katherine Henry & Joanne N. Wood

  2. Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    M. Katherine Henry & Joanne N. Wood

  3. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    M. Katherine Henry & Joanne N. Wood

  4. Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    M. Katherine Henry

  5. PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Joanne N. Wood

  6. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

    Joanne N. Wood

Authors
  1. M. Katherine Henry
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  2. Joanne N. Wood
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Correspondence to M. Katherine Henry.

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Conflicts of interest

The Children’s Hospital of Philadelphia has received payment for Dr. Henry’s and Dr. Wood’s expert testimony following subpoenas in cases of suspected child abuse.

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Henry, M.K., Wood, J.N. What’s in a name? Sentinel injuries in abused infants. Pediatr Radiol 51, 861–865 (2021). https://doi.org/10.1007/s00247-020-04915-7

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  • DOI: https://doi.org/10.1007/s00247-020-04915-7

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