Fifteen Years of Case Presentations at the Helfer Society Annual Meeting: The Ongoing Value of Case Reports. “We See What We Look for. We Look for What We Know.”

Abstract

Unusual child abuse manifestations and abuse mimics are unlikely to be identified in large studies. Over 15 years, the authors selected and moderated Helfer Society Annual Meeting presentations highlighting unusual findings. We review those presentations, highlighting the educational value of case reports. The authors independently reviewed and categorized original presentations. Disagreements were resolved jointly. Summary numbers and supplementary tables are provided. Fifteen annual presentations included 201 individual cases. Abuse had occurred for 62 (30.8%) children, and 142 (70.6%) had abuse mimics. Presentations, over time, changed from mostly by faculty (81.2%) to half by trainees (51.6%). Twenty-five presentations led to publications. Many serious causal conditions and underlying diseases were identified. Unusual abuse manifestations and abuse mimics are unlikely to appear in large institutional or research consortium studies. They are lost in “other” categories of large databases. Being aware of them is important to conduct a thorough differential diagnosis. Case reports can be important presentation opportunities, can highlight unusual conditions, and can be springboards to further research. The role of child abuse paediatricians is not only to diagnose abuse but also to conduct thorough medical evaluations and consider broad differential diagnoses. In doing so, many serious nonabusive conditions can be identified.