Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-30T00:03:15.859Z Has data issue: false hasContentIssue false

Chapter 13 - Evidence-based radiology and child abuse

from Section I - Skeletal trauma

Published online by Cambridge University Press:  05 September 2015

By
Christopher S. Greeley
Edited by
Paul K. Kleinman
Christopher S. Greeley
Affiliation:
Professor of Pediatrics at the Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
Paul K. Kleinman
Affiliation:
Children's Hospital Boston
Get access

Summary

Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients. Sackett et al. (1).

EBM and radiology

Much of the foundation of evidence-based medicine (EBM) originated in McMaster University (Ontario, Canada) in the 1990s. Drs. David Sackett and Gordon Guyatt led the Evidence-Based Working Group (2) that framed a “new paradigm” of patient care and medical scholarship which has continued to grow to the present day. At its core, EBM is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (1). In this way, EBM utilizes the experiences and clinical judgment of the practitioner, but overlays a systematic analysis and critical appraisal of the appropriate published literature. The Working Group presented a medical practice that was no longer based solely upon intuition, anecdote, or supposition, but incorporated the assessment of evidence collected through a systematic literature search and reflected upon the clinical practice and experience of the physician. This paradigm shift required the practitioner to develop new skills: systematic literature appraisal, evidence quality rating, and the continued reassessment of personal biases.

There are some excellent comprehensive resources available for a deeper description of EBM (3, 4). While a complete treatise on EBM cannot be replicated here, an understanding of some of the underpinning principles will aid the practitioner in appreciating its importance in the evaluation of suspected child abuse. The framework of EBM has five fundamental steps as outlined by Dr. Sackett (2, 5) and constitute the Critical Appraisal Exercise (2):

  1. Convert these information needs into answerable questions.

  2. Track down, with maximum efficiency, the best evidence with which to answer them (and making increasing use of secondary sources of the best evidence).

  3. Critically appraise that evidence for its validity (closeness to the truth) and usefulness (clinical applicability).

  4. Integrate the appraisal with clinical expertise and apply the results in clinical practice.

  5. Evaluate one’s own performance.

Type
Chapter
Information
Diagnostic Imaging of Child Abuse , pp. 309 - 323
Publisher: Cambridge University Press
Print publication year: 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Sackett, DL, Rosenberg, WM, Gray, J, Haynes, RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71.CrossRefGoogle ScholarPubMed
Guyatt, G, Cairns, J, Churchill, D, Cook, D, Haynes, B, Hirsh, J, et al. Evidence-based medicine. JAMA. 1992;268(17):2420–5.CrossRefGoogle Scholar
Guyatt, G, Rennie, D, Hayward, R. Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. Chicago, IL: AMA Press; 2002.Google Scholar
Straus, SE, Glasziou, P, Richardson, WS, Haynes, RB. Evidence-Based Medicine: How to Practice and Teach EBM, 4th edn. Philadelphia, PA: Churchill Livingstone Elsevier; 2010.Google Scholar
Sackett, DL. Evidence-based medicine. Semin Perinatol. 1997;21(1):3–5.CrossRefGoogle ScholarPubMed
Greenhalgh, T. How to read a paper: getting your bearings (deciding what the paper is about). BMJ. 1997;315(7102):243–6.CrossRefGoogle Scholar
Vandenbroucke, JP. In defense of case reports and case series. Ann Intern Med. 2001;134(4):330–4.CrossRefGoogle ScholarPubMed
Doll, R, Hill, AB. Mortality in relation to smoking: 10 years’ observations of British doctors. BMJ. 1964;1(5395):1399–410.CrossRefGoogle Scholar
Cook, DJ, Mulrow, CD, Haynes, RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997;126(5):376–80.CrossRefGoogle ScholarPubMed
Geddes, J. Answering clinical questions about prognosis. Evid Based Ment Health. 2000;3(4):100–1.CrossRefGoogle Scholar
Greenhalgh, T. How to read a paper: Papers that report diagnostic or screening tests. BMJ. 1997;315(7107):540–3.CrossRefGoogle ScholarPubMed
Evans, D. Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interventions. J Clin Nurs. 2003;12(1):77–84.CrossRefGoogle ScholarPubMed
Kemp, AM, Dunstan, F, Harrison, S, Morris, S, Mann, M, Rolfe, K, et al. Patterns of skeletal fractures in child abuse: systematic review. BMJ. 2008;337:a1518.CrossRefGoogle ScholarPubMed
Kemp, AM, Jaspan, T, Griffiths, J, Stoodley, N, Mann, MK, Tempest, V, et al. Neuroimaging: what neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review. Arch Dis Child. 2011;96(12):1103–12.CrossRefGoogle ScholarPubMed
Kemp, AM, Joshi, AH, Mann, M, Tempest, V, Liu, A, Holden, S, et al. What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review. Arch Dis Child. 2010;95(5):355–60.CrossRefGoogle ScholarPubMed
Kemp, AM, Rajaram, S, Mann, M, Tempest, V, Farewell, D, Gawne-Cain, ML, et al. What neuroimaging should be performed in children in whom inflicted brain injury (IBI) is suspected? A systematic review. Clin Radiol. 2009;64(5):473–83.CrossRefGoogle ScholarPubMed
Donohoe, M. Evidence-based medicine and shaken baby syndrome: part I: literature review, 1966–1998. Am J Forensic Med Pathol. 2003;24(3):239–42.CrossRefGoogle ScholarPubMed
US Preventive Services Task Force. US Preventive Services Task Force Grade Definitions, 2008. Available from .
US Preventive Services Task Force. US Preventive Services Task Force Recommendations, 2013. Available from .
Hill, AB. The environment and disease: association or causation?Proc R Soc Med. 1965;58:295–300.Google ScholarPubMed
Schunemann, H, Hill, S, Guyatt, G, Akl, EA, Ahmed, F. The GRADE approach and Bradford Hill’s criteria for causation. J Epidemiol Community Health. 2011;65(5):392–5.CrossRefGoogle ScholarPubMed
Dodd, JD. Evidence-based practice in radiology: steps 3 and 4 – appraise and apply diagnostic radiology literature. Radiology. 2007;242(2):342–54.CrossRefGoogle ScholarPubMed
Medina, LS, Applegate, KE, Blackmore, CC. Evidence-based Imaging in Pediatrics: Optimizing Imaging in Pediatric Patient Care: New York, NY: Springer; 2010.CrossRefGoogle Scholar
Staunton, M. Evidence-based radiology: steps 1 and 2 – asking answerable questions and searching for evidence. Radiology. 2007;242(1):23–31.CrossRefGoogle ScholarPubMed
Evidence-Based Radiology Working Group. Evidence-based radiology: a new approach to the practice of radiology. Radiology. 2001;220(3):566–75.CrossRefGoogle Scholar
Thornbury, JR. Intermediate outcomes: diagnostic and therapeutic impact. Acad Radiol. 1999;6(Suppl. 1):S58–65.CrossRefGoogle ScholarPubMed
Centre For Evidence Based Medicine. Diagnostic Study Appraisal Worksheet, 2010. Available from .
Oxford Centre for Evidence-based Medicine Working Group. Levels of Evidence 1 (March 2009). Available from .
Loy, CT, Irwig, L. Accuracy of diagnostic tests read with and without clinical information: a systematic review. JAMA. 2004;292(13):1602–9.CrossRefGoogle ScholarPubMed
Pannucci, CJ, Wilkins, EG. Identifying and avoiding bias in research. Plast Reconstr Surg. 2010;126(2):619–25.CrossRefGoogle ScholarPubMed
Sica, GT. Bias in research studies. Radiology. 2006;238(3):780–9.CrossRefGoogle ScholarPubMed
Croskerry, P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003;78(8):775–80.CrossRefGoogle Scholar
Vick, A, Estrada, CA, Rodriguez, JM. Clinical reasoning for the infectious disease specialist: a primer to recognize cognitive biases. Clin Infect Dis. 2013;57(4):573–8.CrossRefGoogle ScholarPubMed
Winter, SC, Quaghebeur, G, Richards, PG. Unusual cervical spine injury in a one year old. Injury. 2003;34(4):316–19.CrossRefGoogle Scholar
Squier, W. The triad of retinal haemorrhage, subdural haemorrhage and encephalopathy in an infant unassociated with evidence of physical injury is not the result of shaking but is most likely to have been caused by a natural disease. The ‘Yes’ case. J Prim Health Care. 2011;3(2):159–64.Google Scholar
Willoughby, R, Dhonau, H, Ericksen, K, Cappozzo, D, Kazmierczak, J, Davis, J, et al. Recovery of a patient from clinical rabies – Wisconsin, 2004. MMWR Morb Mortal Wkly Rep. 2004;53(50):1171–3.Google Scholar
McFadden, RD. Pilot is hailed after jetliner’s icy plunge. New York Times. 2009.
Findley, KA, Barnes, PD, Moran, DA, Squier, W. Shaken baby syndrome, abusive head trauma and actual innocence: getting it right. Hous J Health L & Pol'y. 2012;12:209–312.Google Scholar
Geddes, JF, Plunkett, J. The evidence base for shaken baby syndrome. BMJ. 2004;328(7442):719–20.CrossRefGoogle ScholarPubMed
Squier, W. Shaken baby syndrome: the quest for evidence. Dev Med Child Neurol. 2008;50(1):10–14.CrossRefGoogle ScholarPubMed
Greeley, CS. Infant fatality. Semin Pediatr Neurol. 2010;17(4):275–8; author reply 279–80.CrossRefGoogle ScholarPubMed
Smith, GC, Pell, JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ. 2003;327(7429):1459–61.CrossRefGoogle ScholarPubMed
Lloyd, J, Willey, EN, Galaznik, JG, Lee, WE, Luttner, SE. Biomechanical evaluation of head kinematics during infant shaking versus pediatric activities of daily living. J Forensic Biomech. 2011;2:F110601.CrossRefGoogle Scholar
Feynman, RP. The Character of Physical Law. Cambridge, MA: MIT Press; 1967.Google Scholar
Fraser, AG, Dunstan, FD. On the impossibility of being expert. BMJ. 2010;341:c6815.CrossRefGoogle ScholarPubMed
Steen, RG. Misinformation in the medical literature: what role do error and fraud play?J Med Ethics. 2011;37(8):498–503.CrossRefGoogle ScholarPubMed
Wager, E, Williams, P. Why and how do journals retract articles? An analysis of Medline retractions 1988–2008. J Med Ethics. 2011;37(9):567–70.CrossRefGoogle ScholarPubMed
Van Noorden, R. Open access: the true cost of science publishing. Nature. 2013;495(7442):426–9.CrossRefGoogle ScholarPubMed
Grahame-Smith, D. Evidence based medicine: Socratic dissent. BMJ. 1995;310(6987):1126–7.CrossRefGoogle ScholarPubMed
Evidence-based medicine, in its place [Comments]. Lancet. 1995;346(8978):785.CrossRef
Barnes, PD. Imaging of nonaccidental injury and the mimics: issues and controversies in the era of evidence-based medicine. Radiol Clin North Am. 2011;49(1):205–29.CrossRefGoogle ScholarPubMed
Paterson, CR. Osteogenesis imperfecta and other bone disorders in the differential diagnosis of unexplained fractures. J R Soc Med. 1990;83(2):72–4.CrossRefGoogle ScholarPubMed
Paterson, CR, Burns, J, McAllion, SJ. Osteogenesis imperfecta: the distinction from child abuse and the recognition of a variant form. Am J Med Genet. 1993;45(2):187–92.CrossRefGoogle ScholarPubMed
Ablin, DS, Sane, SM. Non-accidental injury: confusion with temporary brittle bone disease and mild osteogenesis imperfecta. Pediatr Radiol. 1997;27(2):111–3.CrossRefGoogle ScholarPubMed
Bawle, EV. Osteogenesis imperfecta vs. child abuse. Am J Med Genet. 1994;49(1):131–2.CrossRefGoogle ScholarPubMed
Carty, H. Osteogenesis imperfecta, non-accidental injury, and temporary brittle bone disease. Arch Dis Child. 1995;72:172–4.CrossRefGoogle Scholar
Chapman, S, Hall, CM. Non-accidental injury or brittle bones. Pediatr Radiol. 1997;27(2):106–10.CrossRefGoogle ScholarPubMed
Lynch, MA. A judicial comment on temporary brittle bone disease. Arch Dis Child. 1995;73(4):379.CrossRefGoogle ScholarPubMed
Paterson, C. Reply to Dr. Bawle: temporary brittle bone disease. Am J Med Genet. 1994;49:132.CrossRef
Paterson, C, Burns, J, McAllion, S. Osteogenesis imperfecta variant vs. child abuse: Reply. (Letter to the editor.)Am J Med Genet. 1995;56:117–18.CrossRefGoogle Scholar
Paterson, CR, McAllion, SJ. Child abuse and osteogenesis imperfecta. Br Med J (Clin Res Ed). 1987;295(6612):1561.CrossRefGoogle ScholarPubMed
Shaw, DG, Hall, CM, Carty, H. Osteogenesis imperfecta: the distinction from child abuse and the recognition of a variant form. Am J Med Genet. 1995;56(1):116–18.CrossRefGoogle ScholarPubMed
Smith, R. Osteogenesis imperfecta, non-accidental injury, and temporary brittle bone disease. Arch Dis Child. 1995;72(2):169–71; discussion 171–6.CrossRefGoogle ScholarPubMed
Taitz, LS. Child abuse and osteogenesis imperfecta. Br Med J (Clin Res Ed). 1987;295(6606):1082–3.CrossRefGoogle ScholarPubMed
Wynne, JM, Hobbs, CJ. Osteogenesis imperfecta, non-accidental injury and temporary brittle bone disease. Arch Dis Child. 1995;72:171–2.CrossRefGoogle Scholar
Paterson, C, McAllion, S. Child abuse and osteogenesis imperfacta. BMJ. 1988;296:644.CrossRefGoogle Scholar
Paterson, CR. Child abuse or copper deficiency?Br Med J (Clin Res Ed). 1987;295(6591):213–14.CrossRefGoogle ScholarPubMed
Mathew, MO, Ramamohan, N, Bennet, GC. Importance of bruising associated with paediatric fractures: prospective observational study. BMJ. 1998;317(7166):1117–18.CrossRefGoogle ScholarPubMed
Peters, ML, Starling, SP, Barnes-Eley, ML, Heisler, KW. The presence of bruising associated with fractures. Arch Pediatr Adolesc Med. 2008;162(9):877–81.CrossRefGoogle ScholarPubMed
Kellogg, ND, American Academy of Pediatrics Committee on Child Neglect. Evaluation of suspected child physical abuse. Pediatrics. 2007;119(6):1232–41.CrossRefGoogle Scholar
Meyer, JS, Gunderman, R, Coley, BD, Bulas, D, Garber, M, Karmazyn, B, et al. ACR Appropriateness Criteria® on suspected physical abuse – child. J Am Coll Radiol. 2011;8(2):87–94.CrossRefGoogle ScholarPubMed
Section on Radiology, American Academy of Pediatrics. Diagnostic imaging of child abuse. Pediatrics. 2009;123(5):1430–5.CrossRefGoogle Scholar
Bennett, BL, Chua, MS, Care, M, Kachelmeyer, A, Mahabee-Gittens M. Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal. BMC Res Notes. 2011;4:354.CrossRefGoogle Scholar
Carty, H. Commentary on: A survey of non-accidental injury imaging in England, Scotland and Wales and observational study of skeletal surveys in suspected non-accidental injury. Clin Radiol. 2003;58(9):694–5.CrossRefGoogle ScholarPubMed
Duffy, SO, Squires, J, Fromkin, JB, Berger, RP. Use of skeletal surveys to evaluate for physical abuse: analysis of 703 consecutive skeletal surveys. Pediatrics. 2011;127(1):e47–52.CrossRefGoogle ScholarPubMed
Harper, NS, Eddleman, S, Lindberg, DM, Ex, SI. The utility of follow-up skeletal surveys in child abuse. Pediatrics. 2013;131(3):e672–8.CrossRefGoogle ScholarPubMed
Singh, R, Squires, J, Fromkin, JB, Berger, RP. Assessing the use of follow-up skeletal surveys in children with suspected physical abuse. J Trauma Acute Care Surg. 2012;73(4):972–6.CrossRefGoogle ScholarPubMed
Amir, J, Katz, K, Grunebaum, M, Yosipovich, Z, Wielunsky, E, Reisner, SH. Fractures in premature infants. J Pediatr Orthop. 1988;8(1):41–4.CrossRefGoogle ScholarPubMed
Gefter, WB, Epstein, DM, Anday, EK, Dalinka, MK. Rickets presenting as multiple fractures in premature infants on hyperalimentation. Radiology. 1982;142(2):371–4.CrossRefGoogle ScholarPubMed
Lucas-Herald, A, Butler, S, Mactier, H, McDevitt, H, Young, D, Ahmed, SF. Prevalence and characteristics of rib fractures in ex-preterm infants. Pediatrics. 2012;130(6):1116–19.CrossRefGoogle ScholarPubMed
Toomey, F, Hoag, R, Batton, D, Vain, N. Rickets associated with cholestasis and parenteral nutrition in premature infants. Radiology. 1982;142(1):85–8.CrossRefGoogle ScholarPubMed
Caffey, J. Some traumatic lesions in growing bones other than fractures and dislocations: clinical and radiological features: The Mackenzie Davidson Memorial Lecture. Br J Radiol. 1957;30(353):225–38.CrossRefGoogle ScholarPubMed
Kleinman, PK, Marks, SC, Blackbourne, B. The metaphyseal lesion in abused infants: a radiologic–histopathologic study. AJR. 1986;146(5):895–905.CrossRefGoogle ScholarPubMed
Kleinman, PK, Schlesinger, AE. Mechanical factors associated with posterior rib fractures: laboratory and case studies. Pediatr Radiol. 1997;27(1):87–91.CrossRefGoogle ScholarPubMed
Kwon, DS, Spevak, MR, Fletcher, K, Kleinman, PK. Physiologic subperiosteal new bone formation: prevalence, distribution, and thickness in neonates and infants. AJR. 2002;179(4):985–8.CrossRefGoogle ScholarPubMed
Paterson, CR. Temporary brittle bone disease: fractures in medical care. Acta Paediatr. 2009;98(12):1935–8.CrossRefGoogle ScholarPubMed
Paterson, CR. Vitamin D deficiency rickets and allegations of non-accidental injury. Acta Paediatr. 2009;98(12):2008–12.CrossRefGoogle ScholarPubMed
Paterson, C. Vitamin D deficiency: a diagnosis often missed. Br J Hosp Med (Lond). 2011;72(8):456–8, 460–2.CrossRefGoogle ScholarPubMed
Paterson, CR. Vitamin D deficiency and fractures in childhood. Pediatrics. 2011;127(5):973–4.CrossRefGoogle ScholarPubMed
Paterson, CR. Bone disorders that cause fractures and mimic non-accidental injury. Acta Paediatr. 2010;99(9):1281–2.CrossRefGoogle ScholarPubMed
Paterson, CR, Monk, EA. Temporary brittle bone disease: association with intracranial bleeding. J Pediatr Endocinol Metab. 2013;26(5–6):417–26.Google ScholarPubMed
Paterson, CR. Temporary brittle bone disease: the current position. Arch Dis Child. 2011;96(9):901–2.CrossRefGoogle ScholarPubMed
Paterson, CR, Monk, EA. Clinical and laboratory features of temporary brittle bone disease. J Pediatr Endocinol Metab. 2014;27(1–2):37–45.
Paterson, C, Monk, EA. Long-term follow-up of children thought to have temporary brittle bone disease. Pediatr Health Med Ther. 2011;2011(2):55–8.CrossRefGoogle Scholar
Press, D. Pediatric Health, Medicine and Therapeutics; fees for publication. Available from .
Journal of Pediatric Endocrinology and Metabolism. Aims and scope, 2013. Available from .
Paterson, CR, McAllion, SJ. Differentiation of child abuse from osteogenesis imperfecta. AJR. 1990;155(6):1346–7.CrossRefGoogle ScholarPubMed
Miller, ME, Hangartner, TN. Temporary brittle bone disease: association with decreased fetal movement and osteopenia. Calcif Tissue Int. 1999;64(2):137–43.CrossRefGoogle ScholarPubMed
Miller, ME. The lesson of temporary brittle bone disease: all bones are not created equal. Bone. 2003;33(4):466–74.CrossRefGoogle Scholar
Frost, HM. Perspectives: a proposed general model of the “mechanostat” (suggestions from a new skeletal-biologic paradigm). Anat Rec. 1996;244(2):139–47.3.0.CO;2-X>CrossRefGoogle Scholar
Frost, HM. Bone’s mechanostat: a 2003 update. Anat Rec. 2003;275(2):1081–101.CrossRefGoogle ScholarPubMed
Rodriguez, JI, Palacios, J, Ruiz, A, Sanchez, M, Alvarez, I, Demiguel, E. Morphological changes in long bone development in fetal akinesia deformation sequence: an experimental study in curarized rat fetuses. Teratology. 1992;45(2):213–21.CrossRefGoogle ScholarPubMed
Rodriguez, JI, Garcia-Alix, A, Palacios, J, Paniagua, R. Changes in the long bones due to fetal immobility caused by neuromuscular disease. A radiographic and histological study. J Bone Joint Surg Am. 1988;70(7):1052–60.CrossRefGoogle Scholar
Miller, M. The death of temporary brittle bone disease is premature. Acta Paediatr. 2009;98(12):1871–3.CrossRefGoogle ScholarPubMed
Garcia, VF, Gotschall, CS, Eichelberger, MR, Bowman, LM. Rib fractures in children: a marker of severe trauma. J Trauma. 1990;30(6):695–700.CrossRefGoogle ScholarPubMed
Darling, SE, Done, SL, Friedman, SD, Feldman, KW. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures. Pediatr Radiol. 2014;44(10):1230–6.CrossRefGoogle ScholarPubMed
Pennock, RT. Can’t philosophers tell the difference between science and religion?: Demarcation revisited. Synthese. 2009;178(2):177–206.CrossRefGoogle Scholar
Pigliucci, M. Nonsense on Stilts: How to Tell Science from Bunk. Chicago, IL: University of Chicago Press; 2010.CrossRefGoogle Scholar
Pigliucci, M. The demarcation problem: a (belated) response to Laudan. In Piglucci M, Boudry M, eds. Philosophy of Pseudoscience: Reconsidering the Demarcation Problem. 2013, p. 9.
Chapman, S. Child abuse or copper deficiency? A radiological view. Br Med J (Clin Res Ed). 1987;294(6584):1370.CrossRefGoogle ScholarPubMed
Palacios, J, Rodriguez, JI. Extrinsic fetal akinesia and skeletal development: a study in oligohydramnios sequence. Teratology. 1990;42(1):1–5.CrossRefGoogle ScholarPubMed
Miller, M. Fractures during physical therapy. Pediatr Radiol. 2002;32(7):536–7.CrossRefGoogle ScholarPubMed
Miller, M. Another perspective as to the cause of bone fractures in potential child abuse. Pediatr Radiol. 2000;30(7):A495.CrossRefGoogle ScholarPubMed
Miller, M. Another perspective on the cause of metaphyseal fractures. Pediatr Radiol. 2008;38(5):598–9; author reply 600.CrossRefGoogle ScholarPubMed
Chalumeau, M, Foix-l’Helias, L, Scheinmann, P, Zuani, P, Gendrel, D, Ducou-le-Pointe, H. Author’s reply. Pediatr Radiol. 2003;33(10):735–6.CrossRefGoogle Scholar
O’Connell, AM, Donoghue, VB. Classic metaphyseal lesions follow uncomplicated caesarean section NOT brittle bone disease. Pediatr Radiol. 2008;38(5):600.CrossRefGoogle Scholar
Sisler, C, Rooks, V, Burton, B. Reply. Pediatr Radiol. 2000;30(7):B495–6.CrossRef
Murrie, DC, Boccaccini, MT, Guarnera, LA, Rufino, KA. Are forensic experts biased by the side that retained them?Psychol Sci. 2013;24(10):1889–97.CrossRefGoogle Scholar
Mnookin, JL. Expert evidence, partisanship, and epistemic competence. Brook L Rev. 2007;73:1009.Google Scholar
Wood, BP. Commentary on a critical review of the classic metaphyseal lesion: traumatic or metabolic?AJR Am J Roentgenol. 2014;202(1):197–8.CrossRefGoogle ScholarPubMed
Ayoub, DM, Hyman, C, Cohen, M, Miller, M. A critical review of the classic metaphyseal lesion: traumatic or metabolic?. AJR Am J Roentgenol. 2014;202(1):185–96.CrossRefGoogle ScholarPubMed
Perez-Rossello, JM, McDonald, AG, Rosenberg, AE, Tasi, A, Kleinman, PK. Absence of rickets in infants with fatal abusive head trauma and classic metaphyseal lesions. Radiology. 2015;epub 2015/02/17.

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Evidence-based radiology and child abuse
    • By Christopher S. Greeley, Professor of Pediatrics at the Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
  • Edited by Paul K. Kleinman
  • Book: Diagnostic Imaging of Child Abuse
  • Online publication: 05 September 2015
  • Chapter DOI: https://doi.org/10.1017/CBO9780511862366.021
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Evidence-based radiology and child abuse
    • By Christopher S. Greeley, Professor of Pediatrics at the Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
  • Edited by Paul K. Kleinman
  • Book: Diagnostic Imaging of Child Abuse
  • Online publication: 05 September 2015
  • Chapter DOI: https://doi.org/10.1017/CBO9780511862366.021
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Evidence-based radiology and child abuse
    • By Christopher S. Greeley, Professor of Pediatrics at the Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
  • Edited by Paul K. Kleinman
  • Book: Diagnostic Imaging of Child Abuse
  • Online publication: 05 September 2015
  • Chapter DOI: https://doi.org/10.1017/CBO9780511862366.021
Available formats
×