Whole-body STIR MR imaging in suspected child abuse: An alternative to skeletal survey radiography?

Child abuse is a major problem worldwide. An early and reliable recognition and diagnostic work up is important for the management of these children and their caregivers. Radiological skeletal surveys in combination with brain imaging are mandatory in the initial evaluation. In selected cases, repeat radiography and/or bone scintigraphy is necessary. The radiation dose from these studies is significant. Whole-body STIR MR imaging permits evaluation of the entire skeleton and all viscera with a single examination while avoiding ionizing radiation. We report on a 2-month-old female suspected victim of child abuse in whom whole-body STIR MR imaging revealed multiple rib fractures suggestive of child abuse that were only partially recognised by conventional radiography. Our case suggests that whole-body STIR MR imaging should be considered as an alternative imaging modality in children in whom child abuse is suspected.