Better training and information can help to disarm abusers

One of the most memorable interviews I have ever conducted was with Prof. Helen Carty in 1991. I had heard that she was a world authority on the imaging of child abuse and that she was doing some impressive work at Alder Hey, the main children's hospital in Liverpool, U.K.

As a relative newcomer to medical publishing, I was fascinated to learn more about how technology could help, and Carty did not disappoint. She had a rare ability to convey her ideas, procedures, and research findings clearly and simply. She stressed the need for objectivity and a careful examination of the facts, and she argued that jumping to a premature conclusion about potential abuse was the biggest danger facing both pediatricians and radiologists.

When I asked Carty how widespread abuse was, she told me to look at the shelves and shelves of patient files on the large wall behind her. There were several hundred files in total, and they consisted only of current cases of suspected abuse.

Comprehensive guidelines now exist in this highly sensitive and complex area. Carty, who was president of ECR 2004, would no doubt be delighted because the guidelines promise greater uniformity and standardization of care. Furthermore, it must be a step forward to have such practical information available to all.

The 60-page document, "Standards for Radiological Investigations of Suspected Non-accidental Injury," is available free of charge on the U.K. Royal College of Radiologists' website. It explains how each modality can be used and provides valuable discussion of imaging techniques in head injury and other suspected neurological trauma. It also addresses radiation safety issues. The list of 88 references offers plenty of opportunities for further reading.

Appropriate training is vital to ensure radiologists are comfortable in their role of providing support for other healthcare professionals, said RCR president and DI Europe Editorial Advisory Board member Prof. Andy Adam in the foreword to this document. He believes pediatricians and radiologists have a particular responsibility to ensure child safety where there are concerns that a child may have suffered significant harm, and he wants the principles of child protection to become a critical component of training for all clinical radiologists. Our new columnist, Dr. Paul Dubbins, was chair of the 10-strong editorial group that was responsible for these guidelines, further enhancing the document's credibility.

You can read more about nonaccidental injury in this edition's lead news story, which is based on a session held at the 2008 UK Radiological Congress. It is really encouraging that the radiological profession is addressing this issue with vigor and determination.