Skeletal Surveys for Young Children with Intracranial Hemorrhage

Abusive head trauma is an important cause of morbidity and mortality for young children; however, even in children with recognized brain injury, the abuse is often missed. Skeletal surveys identify additional abusive fractures in many children, but their use is highly variable and disproportionate according to race and socioeconomic status.

These authors developed guidelines for skeletal survey in children <24 months old with subdural or epidural hemorrhage. Using a combination of systematic review and modified Delphi method, a multidisciplinary expert panel rated the appropriateness of skeletal survey for several scenarios, all of which specified that the patient had not been involved in a motor vehicle collision, did not have coagulopathy,…