Natalie Z Wong1, Tony Rosen2, Allen M Sanchez3, Elizabeth M Bloemen4, Kevin W Mennitt3, Keith Hentel3, Refky Nicola5, Kieran J Murphy6, Veronica M LoFaso7, Neal E Flomenbaum8, Mark S Lachs7. 1. Division of Emergency Medicine, Weill Cornell Medical College, New York, New York, USA; Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA. 2. Division of Emergency Medicine, Weill Cornell Medical College, New York, New York, USA. Electronic address: aer2006@med.cornell.edu. 3. Department of Radiology, Weill Cornell Medical College, New York, New York, USA. 4. University of Colorado Medical School, Aurora, Colorado, USA. 5. Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA. 6. Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. 7. Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA. 8. Division of Emergency Medicine, Weill Cornell Medical College, New York, New York, USA.
Abstract
PURPOSE: Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification. METHODS: We present 2 cases to begin characterisation of the radiographic findings in elder abuse. RESULTS: Findings from these cases demonstrate similarities to suspicious findings in child abuse including high-energy fractures that are inconsistent with reported mechanisms and the coexistence of acute and chronic injuries. Specific injuries uncommon to accidental injury are also noted, including a distal ulnar diaphyseal fracture. CONCLUSIONS: We hope to raise awareness of elder abuse among diagnostic radiologists to encourage future large-scale research, increased focus on chronic osseous findings, and the addition of elder abuse to differential diagnoses.
PURPOSE: Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification. METHODS: We present 2 cases to begin characterisation of the radiographic findings in elder abuse. RESULTS: Findings from these cases demonstrate similarities to suspicious findings in child abuse including high-energy fractures that are inconsistent with reported mechanisms and the coexistence of acute and chronic injuries. Specific injuries uncommon to accidental injury are also noted, including a distal ulnar diaphyseal fracture. CONCLUSIONS: We hope to raise awareness of elder abuse among diagnostic radiologists to encourage future large-scale research, increased focus on chronic osseous findings, and the addition of elder abuse to differential diagnoses.
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