RESPONSE OF MEDICAL IMAGING IN CHILD-ABUS E - THE SILVERMAN-AMBROISE-TARDIEU-SYNDROME

Imaging procedures offer an important contribution to the syndrome of the abused child that F.N. Silverman himself proposes to call the Ambr oise Tardieu syndrome. First they disclose and analyse the lesions whi ch may involve bones, encephalon or spinal cord, viscera, soft tissues . Then they must answer four questions: Traumatic lesion or normal var iant? If traumatic, are there arguments pointing to abuse, for instanc e, multiple bone lesions of different ages and more specifically fract ures of ribs, calvicle, spine, pelvis, phalanxes? Is there a possibili ty of a general disease explaining such traumatic lesions? Etiologies are revised including sensibility deficits. Finally are the bad treatm ents inflicted with an intention of hurting, injuring or destroying? T he answer results of a discussion with clinicians and social intervene rs but some lesions, as phalanx fractures, may be determining. In this situation that involves the vital prognosis and may induce severe seq uellae the imaging strategy, fully described, is of paramount importan ce.