Prise en charge d’une suspicion de maltraitance chez l’enfant : le point de vue du médecin nucléaire

In the context of child abuse, post-traumatic bone lesions are the most commonly observed after cutaneous lesions. Therefore, imaging has an important role to play in diagnosis, especially among the youngest children. Several imaging modalities are now available. While standard radiographs are essential and remain the first-line test, bone scintigraphy is useful for detecting certain recent infra-radiological lesions and types of fractures. Some fractures are more common in the setting of non-accidental trauma, but there is no single pathognomonic lesion. It is the association of multiple fractures associated with the absence of a concordant lesion mechanism that can lead to the diagnosis. The presence of fractures of different ages is an important, but unfortunately, inconsistent diagnostic factor. Bone scans alone do not allow accurate lesion dating. Prompt and multidisciplinary management, high quality imaging and accurate interpretation are essential to the diagnosis of child abuse.