1
|
Demir U, Etli Y, Asirdizer M. Examination of bone fractures in women exposed to domestic violence (Tokat-Turkey). J Forensic Leg Med 2024; 104:102687. [PMID: 38733737 DOI: 10.1016/j.jflm.2024.102687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Fractures are an important symptom of physical violence that will negatively affect the woman's quality of life in the coming years. However, there is limited information in the literature about fractures in women exposed to domestic violence (DV). The aim of this study was to compare fracture development rates and age distributions in women exposed to DV and intimate partner violence (IPV), a component of DV, and women exposed to other physical violence (OV), to determine the incidence of DV cases with and without fractures, and to determine fracture locations in DV cases and to identify diagnostic lesions accompanying fractures. METHODS A retrospective review was made of patients injured as a result of IPV, other domestic violence (ODV) and OV. The data of cases with fracture were analyzed in terms of age groups of the victims and according to location and types of fractures. RESULTS Of the 854 female patients aged >18 years who were admitted to the hospital due to violence, 55.2% were exposed to DV. Most DV victims (87.9%) were assaulted by intimate partners. The incidence of fractures in IPV cases (7.2%), was nearly twice that of ODV and OV cases. The mean age of IPV cases with fractures (42.1 ± 12.1 years) was significantly higher than that of IPV cases without fractures (33.1 ± 11.8 years) (p < 0.05). Most IPV cases (61.8%) were aged <35 years. Most DV cases with fractures (75%) were aged <50 years. Facial/neck injuries (41.5%) and facial fractures (52.6%) were prominent in DV cases. CONCLUSION The results of this study of the presence of facial fractures, especially in women aged <50 years, is an important finding that can alert doctors to potential cases of domestic violence.
Collapse
Affiliation(s)
- Ugur Demir
- Department of Forensic Medicine, Medical Faculty of Harran University, Şanlıurfa, Turkey.
| | - Yasin Etli
- Department of Forensic Medicine, Medical Faculty Hospital of Selcuk University, Konya, Turkey.
| | - Mahmut Asirdizer
- Head of the Department of Forensic Medicine, Medical Faculty of Bahçeşehir University, Istanbul, Turkey.
| |
Collapse
|
2
|
Tang A, Wong A, Khurana B. Imaging of Intimate Partner Violence, From the AJR Special Series on Emergency Radiology. AJR Am J Roentgenol 2023; 220:476-485. [PMID: 36069484 DOI: 10.2214/ajr.22.27973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Intimate partner violence (IPV) is a highly prevalent public health issue with multiple adverse health effects. Radiologists are well suited to assessing a patient's likelihood of IPV. Recognition of common IPV injury mechanisms and resulting target and defensive injury patterns on imaging and understanding of differences between patients who have experienced IPV and those who have not with respect to use of imaging will aid radiologists in accurate IPV diagnosis. Target injuries often involve the face and neck as a result of blunt trauma or strangulation; defensive injuries often involve an extremity. Awareness of differences in injury patterns resulting from IPV-related and accidental trauma can aid radiologists in detecting a mismatch between the provided clinical history and imaging findings to support suspicion of IPV. Radiologists should consider all available current and prior imaging in assessing the likelihood of IPV; this process may be aided by machine learning methods. Even if correctly suspecting IPV on the basis of imaging, radiologists face challenges in acting on that suspicion, including appropriately documenting the findings, without compromising the patient's confidentiality and safety. However, through a multidisciplinary approach with appropriate support mechanisms, radiologists may serve as effective frontline physicians for raising suspicion of IPV.
Collapse
Affiliation(s)
- Anji Tang
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
- Trauma Imaging Research and Innovation Center, Brigham and Women's Health, Boston, MA
| | - Andrew Wong
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Bharti Khurana
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
- Trauma Imaging Research and Innovation Center, Brigham and Women's Health, Boston, MA
| |
Collapse
|
3
|
Mikhael V, Ghabi R, Belahmer A, Kadi R, Guirguis N, Gutzeit A, Froehlich JM, Ferreira E, Higgs T, Dufour MM, Theoret V, Hebert M, Turgeon J, Balcom MC, Khurana B, Matoori S. Intimate partner violence: Defining the pharmacist’s role. Can Pharm J (Ott) 2023; 156:63-70. [PMID: 36969310 PMCID: PMC10034523 DOI: 10.1177/17151635231152450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/28/2022] [Indexed: 02/19/2023]
Affiliation(s)
| | | | | | | | | | - Andreas Gutzeit
- Department of Health Sciences and Medicine, University of Lucerne, and the Institute of Radiology and Nuclear Medicine and Breast Center St. Anna
| | - Johannes M. Froehlich
- Hirslanden Klinik St. Anna, Lucerne, Switzerland; the Clinical Research Group, Klus Lab Zurich, Zurich, Switzerland
| | - Ema Ferreira
- Faculté de Pharmacie
- Département de pharmacie, CHU Ste-Justine, Montreal, Quebec
| | | | | | - Valerie Theoret
- Département de sexologie, Université du Québec à Montréal, Montréal, Quebec
| | - Martine Hebert
- Département de sexologie, Université du Québec à Montréal, Montréal, Quebec
| | - Joane Turgeon
- Faculté de l’éducation permanente, Université de Montréal, Montreal, Quebec
| | | | - Bharti Khurana
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | | |
Collapse
|
4
|
Imaging and Non-imaging Findings of Intimate Partner Violence on the Trauma Service: A Retrospective Analysis of Two Level 1 Trauma Centers. Acad Radiol 2023; 30:312-321. [PMID: 35597753 DOI: 10.1016/j.acra.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE AND OBJECTIVES Intimate partner violence (IPV) is a serious public health issue. This study aims to characterize IPV-related injuries in trauma patients presenting to emergency departments (ED) who required hospitalization. MATERIALS AND METHODS Trauma registries of two Level 1 trauma centers were searched for assault-related ED visits by adults reporting "abuse" over 3 and 5 years to identify IPV victims. Imaging and electronic medical records were reviewed for demographics, injury type, hospital stay, and previous or subsequent presentations for presumed IPV. RESULTS Twenty-nine of 18,465 (0.2%) individuals seen on the trauma service had reported IPV. Majority were women (90%, mean age 37) and Caucasian (69%), over 50% had psychiatric or substance use comorbidities, and 45% reported prior IPV. Blunt trauma (22/29) was more common than penetrating trauma. Soft tissue injuries dominated when including both radiologic and non-radiologic findings. Excluding two patients who were not imaged, most frequent injuries identified on imaging were to the head/face (14/27), followed by the chest (9/27; mainly rib fractures), upper extremity and abdomen (7/27 each). All spinal fractures involved the upper lumbar spine. Synchronous injuries to multiple body regions were common, particularly craniofacial and upper extremity. Twenty-eight of 29 patients scored a grade 3-4 on the IPV severity grading scale. Eight (28%) patients required intensive care unit -level care. One patient passed. Four (14%) patients had prior IPV-related ED presentations. CONCLUSION While craniofacial and soft tissue injuries dominate, IPV can also result in serious thoracoabdominal, extremity and spinal injuries, even death. Multisystem injuries are common with synchronous craniofacial and upper extremity injuries being the most common combination.
Collapse
|
5
|
Women's intimate partner violence versus community violence: Comparing injuries as presented in Iceland's largest emergency department. Int Emerg Nurs 2022; 63:101192. [PMID: 35809482 DOI: 10.1016/j.ienj.2022.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/25/2022] [Accepted: 06/04/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) is a widespread, often unidentified and hidden public health problem, which has serious consequences. The purpose of this study was to describe and compare the clinical characteristics of women's violence inflicted physical injuries, as presented at Iceland's largest Emergency Department (ED). Three groups were created based on registered reason of injury: (1) IPV, (2) community violence (CV) with a history of IPV (HIPV), and (3) CV with no history of IPV. METHODS Data was collected retrospectively by using the Nomesco classification system of external causes of injuries. Participants were adult women, residing in the capital area, visiting the ED during 2005-2019. RESULTS IPV inflicted ED visits declined by 45% during the research period and CV visits declined by 61%. Women in the IPV group had the highest prevalence of repeated new ED visits per 1000 women in the capital area. The majority of IPV occurred in residential areas (86.4%), inflicted by a current partner (54.7%), and included only one perpetrator (95.3%). Women involved in CV were most likely to visit the ED on weekends (p = 0.003) and IPV women were most likely to visit between 08:00 and 16:00 (p < 0.001). Superficial injuries were the most common type of injury among all groups and IPV women were twice as likely (7.1%) to have injuries on their neck than CV women (3.5%). IPV women were most likely to be admitted (3.0%). CONCLUSION Time of ED visit, number of perpetrators and location of assault can be indicators of IPV inflicted injuries, as opposed to otherwise inflicted injuries. Repeated visits, superficial injuries and neck injuries might also be an indicator of IPV, however wounds and sprains and injuries on head and upper limbs are more likely to be non-IPV inflicted.
Collapse
|
6
|
Longitudinal imaging history in early identification of intimate partner violence. Eur Radiol 2021; 32:2824-2836. [PMID: 34797386 DOI: 10.1007/s00330-021-08362-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To describe the imaging findings of intimate partner violence (IPV)-related injury and to evaluate the role of longitudinal imaging review in detecting IPV. METHODS Radiology studies were reviewed in chronological order and IPV-related injuries were recorded among 400 victims of any type of abuse (group 1) and 288 of physical abuse (group 2) from January 2013 to June 2018. The likelihood of IPV was assessed as low/moderate/high based on the review of (1) current and prior anatomically related studies only and (2) longitudinal imaging history consisting of all prior studies. The first radiological study date with moderate/high suspicion was compared to the self-reported date by the victim. RESULTS A total of 135 victims (33.8%) in group 1 and 144 victims (50%) in group 2 demonstrated IPV-related injuries. Musculoskeletal injury was most common (58.2% and 44.5% in groups 1 and 2, respectively; most commonly lower/upper extremity fractures), followed by neurologic injury (20.9% and 32.9% in groups 1 and 2, respectively; most commonly facial injury). With longitudinal imaging history, radiologists were able to identify IPV in 31% of group 1 and 46.5% of group 2 patients. Amongst these patients, earlier identification by radiologists was provided compared to the self-reported date in 62.3% of group 1 (median, 64 months) and in 52.6% of group 2 (median, 69.3 months). CONCLUSIONS Musculoskeletal and neurological injuries were the most common IPV-related injuries. Knowledge of common injuries and longitudinal imaging history may help IPV identification when victims are not forthcoming. KEY POINTS • Musculoskeletal injuries were the most common type of IPV-related injury, followed by neurological injuries. • With longitudinal imaging history, radiologists were able to better raise the suspicion of IPV compared to the selective review of anatomically related studies only. • With longitudinal imaging history, radiologists were able to identify IPV earlier than the self-reported date by a median of 64 months in any type of abuse, and a median of 69.3 months in physical abuse.
Collapse
|
7
|
Upper extremity fractures due to intimate partner violence versus accidental causes. Emerg Radiol 2021; 29:89-97. [PMID: 34626284 PMCID: PMC8501321 DOI: 10.1007/s10140-021-01972-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/15/2021] [Indexed: 02/03/2023]
Abstract
Purpose The purpose of this study is to evaluate the prevalence of intimate partner violence (IPV)-related upper extremity fractures (UEF) in women presenting to US emergency departments (ED) and compare their anatomic location to those due to accidental falls or strikes. Methods An Institutional Review Board exempt, retrospective review of prospectively collected data was performed using the National Electronic Injury Surveillance System’s All Injury Program data from 2005 through 2015 for all UEF sustained in women 15 to 54 years old. Injuries based on reported IPV versus accidental falls or strikes were analyzed accounting for the weighted, stratified nature of the data. Results IPV-related UEF represented 1.7% of all UEF and 27.2% of all IPV fractures. The finger was the most common fracture site in IPV (34.3%) and accidental striking (53.3%) but accounted for only 10% of fall-related UEF. There was a higher proportion of shoulder fractures in IPV (9.2%) compared to accidental falls (7.4%) or strikes (2.9%). The odds of a finger fracture were 4.32 times greater in IPV than falling and of a shoulder fracture were 3.65 greater in IPV than accidental striking (p < 0.0001). Conclusions While the finger is the most common site for IPV UEF, it is also the most common location for accidental striking. A lower proportion of finger fractures in fall and of shoulder/forearm fractures in accidental striking should prompt the radiologist to discuss the possibility of IPV with the ED physician in any woman presenting with a finger fracture due to fall and a shoulder/forearm fracture with a vague history of accidental striking.
Collapse
|
8
|
Neck and Back Sprain and Hand Flexor Tendon Repair Are More Common in Victims of Domestic Violence Compared With Patients Who Were Not Victims of Domestic Violence: A Comparative Study of 1,204,596 Patients Using the National Trauma Data Bank. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2021; 5:01979360-202109000-00002. [PMID: 34491916 PMCID: PMC8416016 DOI: 10.5435/jaaosglobal-d-21-00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to determine the most common orthopedic diagnoses and procedures among patients who experience domestic violence (DV) and to determine whether these were more common in patients who experienced DV compared with those who did not.
Collapse
|
9
|
Ucar AK, Ozdemir H, Guvenc G, Akyuz A. Case stories and Post-violence behavior of women seeking medical attention at the emergency department due to physical violence. J Forensic Leg Med 2021; 80:102174. [PMID: 33932741 DOI: 10.1016/j.jflm.2021.102174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/17/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
SUBJECT The objective of this study is to determine the violence experienced by women who presented to the Emergency Department (ED) due to Intimate Partner Violence (IPV) and their previous experiences of violence. METHOD The descriptive study was conducted with 96 women. The data was analyzed in SPSS 17.0 statistics package program. FINDINGS The average age of the women is X = 35.33 ± 11.72, 35.4% of them are in the 31-40 age group, 69.6% are married, 44.8% are high school graduates, 60.4% are unemployed. It was determined that women who were IPV victims were exposed to violence by being beaten (punching, kicking etc.) at the highest rate (82.3%), and nearly half of them (47.9%) were injured in the head and neck regions. The vast majority of women (86.5%) have been subjected to violence before, only %13.5 of them stated that they experienced violence for the first time. It was found that the majority of women (69.8%) continued to live with the perpetrator after violence. Only three of the women (3.4%) attempted to initiate legal action, and the majority (76.5%) did not intend to take legal action. CONCLUSIONS Healthcare professionals should be aware that most woman presenting to the ED with IPV has a history of violence before it, and that this will probably not be the last. Healthcare professionals should also consider the fact that the victims may be exposed to different types of violence at the same time. It is also recommended that healthcare professionals be trained on policies regarding IPV management and equipped to provide women with the right way out.
Collapse
Affiliation(s)
- Ayse Kilic Ucar
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University Esentepe Hemşirelik Kampüsü, Büyükdere Cad. Yazarlar Sok. No:27, Şişli, İstanbul, Turkey.
| | - Havva Ozdemir
- Gulhane Institute of Health Sciences, University of Health Sciences, Sağlık Bilimleri Üniversitesi Gülhane Sağlık Bilimleri Enstitüsü Müdürlüğü Gülhane Külliyesi Emrah Mah, 06018, Etlik, Keçiören, Ankara, Turkey.
| | - Gulten Guvenc
- Gulhane Faculty of Nursing, University of Health SciencesSağlık Bilimleri Üniversitesi Gülhane Hemşirelik Fakültesi, Gülhane Külliyesi, Emrah Mah, 06018, Etlik, Keçiören, Ankara, Turkey.
| | - Aygul Akyuz
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University Esentepe Hemşirelik Kampüsü, Büyükdere Cad. Yazarlar Sok. No:27, Şişli, İstanbul, Turkey.
| |
Collapse
|
10
|
Biegon A. Considering Biological Sex in Traumatic Brain Injury. Front Neurol 2021; 12:576366. [PMID: 33643182 PMCID: PMC7902907 DOI: 10.3389/fneur.2021.576366] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/08/2021] [Indexed: 11/23/2022] Open
Abstract
Published epidemiological studies of traumatic brain injury (TBI) of all severities consistently report higher incidence in men. Recent increases in the participation of women in sports and active military service as well as increasing awareness of the very large number of women who sustain but do not report TBI as a result of intimate partner violence (IPV) suggest that the number of women with TBI is significantly larger than previously believed. Women are also grossly under-represented in clinical and natural history studies of TBI, most of which include relatively small numbers of women, ignore the role of sex- and age-related gonadal hormone levels, and report conflicting results. The emerging picture from recent studies powered to detect effects of biological sex as well as age (as a surrogate of hormonal status) suggest young (i.e., premenopausal) women are more likely to die from TBI relative to men of the same age group, but this is reversed in the 6th and 7th decades of life, coinciding with postmenopausal status in women. New data from concussion studies in young male and female athletes extend this finding to mild TBI, since female athletes who sustained mild TBI are significantly more likely to report more symptoms than males. Studies including information on gonadal hormone status at the time of injury are still too scarce and small to draw reliable conclusions, so there is an urgent need to include biological sex and gonadal hormone status in the design and analysis of future studies of TBI.
Collapse
Affiliation(s)
- Anat Biegon
- Department of Radiology and Neurology, Stony Brook University School of Medicine, Stony Brook, NY, United States
| |
Collapse
|
11
|
Steyn M, Bacci N, Holland S. Patterning of fractures in a case of intimate partner homicide (IPH). J Forensic Sci 2020; 66:766-774. [PMID: 33201522 DOI: 10.1111/1556-4029.14619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 11/29/2022]
Abstract
South Africa is a country overwhelmed by crime and violence, with very high incidences of abuse against women and children. It is not often that a case of intimate partner homicide is seen in a forensic anthropological context. Here, we report on such a case where the remains of the victim had been buried for some time. The victim was a middle-aged female, while the suspect was a younger adult male. The deceased had suffered massive, repeated trauma during her lifetime with healed fractures and evidence of soft tissue trauma to virtually all parts of her body. A partly healed rib fracture indicates that the abuse continued until shortly before her death. She ultimately succumbed after suffering trauma to her head and face after reportedly being hit by a brick, evidence of which can be seen as perimortem fractures of the face. It is important for forensic anthropologists to identify specific patterns and report on the presence of healed fractures, as they can raise suspicion as to the possibility of chronic abuse. In this case, the evidence suggests a very long period of extreme and repeated trauma, which were apparently not reported or noticed by family members or the medical fraternity.
Collapse
Affiliation(s)
- Maryna Steyn
- Human Variation and Identification Research Unit, School of Anatomical Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Nicholas Bacci
- Human Variation and Identification Research Unit, School of Anatomical Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Shakeera Holland
- Department of Forensic Medicine, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| |
Collapse
|
12
|
Alessandrino F, Keraliya A, Lebovic J, Mitchell Dyer GS, Harris MB, Tornetta P, Boland GWL, Seltzer SE, Khurana B. Intimate Partner Violence: A Primer for Radiologists to Make the "Invisible" Visible. Radiographics 2020; 40:2080-2097. [PMID: 33006922 DOI: 10.1148/rg.2020200010] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Intimate partner violence (IPV) is the physical, sexual, or emotional violence between current or former partners. It is a major public health issue that affects nearly one out of four women. Nonetheless, IPV is greatly underdiagnosed. Imaging has played a significant role in identifying cases of nonaccidental trauma in children, and similarly, it has the potential to enable the identification of injuries resulting from IPV. Radiologists have early access to the radiologic history of such victims and may be the first to diagnose IPV on the basis of the distribution and imaging appearance of the patient's currrent and past injuries. Radiologists must be familiar with the imaging findings that are suggestive of injuries resulting from IPV. Special attention should be given to cases in which there are multiple visits for injury care; coexistent fractures at different stages of healing, which may help differentiate injuries related to IPV from those caused by a stranger; and injuries in defensive locations and target areas such as the face and upper extremities. The authors provide an overview of current methods for diagnosing IPV and define the role of the radiologist in cases of IPV. They also describe a successful diagnostic imaging-based approach for helping to identify IPV, with a specific focus on the associated imaging findings and mechanisms of injuries. In addition, current needs and future perspectives for improving the diagnosis of this hidden epidemic are identified. This information is intended to raise awareness among radiologists, with the ultimate goal of improving the diagnosis of IPV and thus reducing the devastating effects on victims' lives. ©RSNA, 2020.
Collapse
Affiliation(s)
- Francesco Alessandrino
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Abhishek Keraliya
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Jordan Lebovic
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - George Sinclair Mitchell Dyer
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Mitchel B Harris
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Paul Tornetta
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Giles W L Boland
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Steven E Seltzer
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Bharti Khurana
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| |
Collapse
|
13
|
Watane GV, Gosangi B, Thomas R, Gujrathi R, Park H, Harris MB, Khurana B. Incidence and characteristics of spinal injuries in the victims of intimate partner violence (IPV). Emerg Radiol 2020; 28:283-289. [PMID: 33000362 PMCID: PMC7527263 DOI: 10.1007/s10140-020-01853-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the incidence and patterns of the spinal injuries in the victims of physical IPV. MATERIALS AND METHODS With institutional review board (IRB) approval, we retrospectively reviewed patients referred to our institution's domestic violence intervention and prevention program with a diagnosis directly related to physical abuse between January 2013 and June 2018. Electronic health records and radiology reports were reviewed for all patients. RESULTS A total of 21/688 (3%) IPV patients with 41 vertebral injuries were identified. The study population comprised of 19/21 (90%) females. Median age of the included patients was 43 years with a range of 21-72 years. All vertebral injuries were AO type A spinal injuries. Upper lumbar spine (L1 and L2) was the most common level of injury followed by upper to mid-thoracic spine. The reported mechanism of the injury was IPV in 8/21 (38.0%), fall in 8/21(38.0%), and incidental in 5/21 (24.0%). Ten out of 21 (48%) patients had concomitant injuries, most commonly to the craniofacial region 5/21 (23%). Psychiatry history was positive in 17/21 (81%), and substance abuse was positive in 15/21 (71%) of the patients. CONCLUSION Incidence of spinal injuries is relatively low in IPV with morphologic AO type A injury being the most common type of injury and the upper lumbar spine being the most common level of injury.
Collapse
Affiliation(s)
- Gaurav V Watane
- Division of Emergency Radiology, Department of Radiology, Brigham & Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Babina Gosangi
- Department of Radiology, Yale New Haven Health, New Haven, CT, 06510, USA
| | - Richard Thomas
- Lahey Hospital and Medical Center, 41 Mall road, Burlington, MA, 01805, USA
| | - Rahul Gujrathi
- Division of Emergency Radiology, Department of Radiology, Brigham & Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Hyesun Park
- Division of Emergency Radiology, Department of Radiology, Brigham & Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Mitchel B Harris
- Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Bharti Khurana
- Division of Emergency Radiology, Department of Radiology, Brigham & Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
| |
Collapse
|
14
|
Bertoglio B, Corradin S, Cappella A, Mazzarelli D, Biehler-Gomez L, Messina C, Pozzi G, Sconfienza LM, Sardanelli F, Sforza C, De Angelis D, Cattaneo C. Pitfalls of Computed Tomography 3D Reconstruction Models in Cranial Nonmetric Analysis. J Forensic Sci 2020; 65:2098-2107. [PMID: 32809248 DOI: 10.1111/1556-4029.14535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/27/2020] [Accepted: 07/17/2020] [Indexed: 11/27/2022]
Abstract
Many studies in the literature have highlighted the utility of virtual 3D databanks as a substitute for real skeletal collections and the important application of radiological records in personal identification. However, none have investigated the accuracy of virtual material compared to skeletal remains in nonmetric variant analysis using 3D models. The present study investigates the accuracy of 20 computed tomography (CT) 3D reconstruction models compared to the real crania, focusing on the quality of the reproduction of the real crania and the possibility to detect 29 dental/cranial morphological variations in 3D images. An interobserver analysis was performed to evaluate trait identification, number, position, and shape. Results demonstrate a false bone loss in 3D models in some cranial regions, specifically the maxillary and occipital bones in 85% and 20% of the samples. Additional analyses revealed several difficulties in the detection of cranial nonmetric traits in 3D models, resulting in incorrect identification in circa 70% of the traits. In particular, pitfalls included the detection of erroneous position, error in presence/absence rates, in number, and in shape. The lowest percentages of correct evaluations were found in traits localized in the lateral side of the cranium and for the infraorbital suture, mastoid foramen, and crenulation. The present study highlights important pitfalls in CT scan when compared with the real crania for nonmetric analysis. This may have crucial consequences in cases where 3D databanks are used as a source of reference population data for nonmetric traits and pathologies and during bone-CT comparisons for identification purposes.
Collapse
Affiliation(s)
- Barbara Bertoglio
- LABANOF, Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milan, 20133, Italy
| | - Sofia Corradin
- LABANOF, Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milan, 20133, Italy
| | - Annalisa Cappella
- LABANOF, Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milan, 20133, Italy.,Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, Milan, 20133, Italy
| | - Debora Mazzarelli
- LABANOF, Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milan, 20133, Italy.,Fondazione Isacchi Samaja ONLUS, Via Nino Bixio 30, Milan, 20129, Italy
| | - Lucie Biehler-Gomez
- LABANOF, Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milan, 20133, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan, 20161, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, Milan, 20133, Italy
| | - Grazia Pozzi
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan, 20161, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan, 20161, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, Milan, 20133, Italy
| | - Francesco Sardanelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, Milan, 20133, Italy.,IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, Milan, 20097, Italy
| | - Chiarella Sforza
- Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, Milan, 20133, Italy
| | - Danilo De Angelis
- LABANOF, Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milan, 20133, Italy
| | - Cristina Cattaneo
- LABANOF, Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milan, 20133, Italy
| |
Collapse
|
15
|
George E, Phillips CH, Shah N, Lewis-O'Connor A, Rosner B, Stoklosa HM, Khurana B. Radiologic Findings in Intimate Partner Violence. Radiology 2019; 291:62-69. [PMID: 30720401 DOI: 10.1148/radiol.2019180801] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To assess the radiologic findings associated with intimate partner violence (IPV). Materials and Methods Electronic medical records of 185 patients referred to the IPV support program from the emergency department (ED) between January 2015 and October 2016 were retrospectively reviewed and compared with an age- and sex-matched control group of 555 subjects (1:3 ratio of IPV victims to control subjects) who presented to the ED. Reports of all imaging studies performed within 5 years prior to the index ED visit were reviewed. Results The majority of patients who experienced IPV (mean age, 34.2 years ± 12.2 [standard deviation]) were female (178 of 185 [96.2%]) and were largely African American (69 of 185 [37.3%]). Demographic and clinical variables independently associated with IPV were race (odds ratio [OR] range, 3.2-5.9; 95% confidence interval [CI]: 1.8, 12.7), psychiatric comorbidities (OR, 5.4; 95% CI: 3.4, 8.8), and homelessness (OR, 13.0; 95% CI: 5.4, 31.2). IPV victims underwent more imaging studies in the preceding 5 years (median, four studies) than did control subjects (median, one study). Obstetric-gynecologic findings (OR, 4.4; 95% CI: 2.1, 9.6) and acute fractures (OR, 2.4, 95% CI: 1.1, 5.3) seen on images were independently associated with IPV. The addition of imaging findings to demographic and clinical variables increased the area under the receiver operating characteristic curve (AUC) of the multivariate model to detect IPV (0.87 vs 0.86, P < .01), and the cross-validated multivariate model had an AUC of 0.85. Acute fractures involved the face or skull (range, P < .01 to P = .05), and chronic fractures affected the extremities and nasal bone (P < .01 and P = .05, respectively) more frequently in the IPV group than in the control group. Conclusion Intimate partner violence victims undergo more imaging studies and have a higher frequency of potential violence-related imaging findings when compared with age- and sex-matched control subjects. © RSNA, 2019 See also the editorial by Flores and Narayan in this issue.
Collapse
Affiliation(s)
- Elizabeth George
- From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.)
| | - Catherine H Phillips
- From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.)
| | - Nandish Shah
- From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.)
| | - Annie Lewis-O'Connor
- From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.)
| | - Bernard Rosner
- From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.)
| | - Hanni M Stoklosa
- From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.)
| | - Bharti Khurana
- From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.)
| |
Collapse
|
16
|
Zark L, Hammond SM, Williams A, Pilgrim JL. Family violence in Victoria, Australia: a retrospective case-control study of forensic medical casework. Int J Legal Med 2019; 133:1537-1547. [DOI: 10.1007/s00414-019-02000-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 01/11/2019] [Indexed: 11/29/2022]
|
17
|
Crenshaw DA, Caprioli S. The Nature of Intimate Wounding and the “Shadow Abuser”. JOURNAL OF HUMANISTIC PSYCHOLOGY 2018. [DOI: 10.1177/0022167818815587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Sarah Caprioli
- Trauma Therapist in Private Practice, Poughkeepsie, NY, USA
| |
Collapse
|
18
|
Russo A, Reginelli A, Pignatiello M, Cioce F, Mazzei G, Fabozzi O, Parlato V, Cappabianca S, Giovine S. Imaging of Violence Against the Elderly and the Women. Semin Ultrasound CT MR 2018; 40:18-24. [PMID: 30686363 DOI: 10.1053/j.sult.2018.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Emergency department assessment is a critical opportunity to identify elder abuse and violence against women, which represent a growing problem, requiring the attention of health care systems. Elder abuse is most frequently perpetrated by family members because of the higher levels of stress, burnout, and financial problems affecting the caregivers that can even lead to deadly consequences. Intimate partner violence is defined as physical, sexual, or psychological harm caused to another by a current or former partner or spouse, and can range from a single acute hit to chronic battering, varying in frequency and severity. Radiologists have a critical role in detecting those injury findings suggestive of abuse and violence. When appropriate, additional information about the social circumstances in which an injury took place, linked with imaging findings, may also be helpful in diagnosing abuse. The purpose of this article is to highlight the role of diagnostic imaging in the detection of lesions compatible with domestic abuse in elderly patients and women, and to allow the recognition of the alterations most frequently associated with this type of violence.
Collapse
Affiliation(s)
- Anna Russo
- Department of Radiology, SG Moscati Hospital, Aversa Caserta, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, Radiology and Radiotherapy, University of Campania Luigi Vanvitelli. Piazza Miraglia, Naples Italy.
| | - Maria Pignatiello
- Department of Precision Medicine, Radiology and Radiotherapy, University of Campania Luigi Vanvitelli. Piazza Miraglia, Naples Italy
| | - Fabrizio Cioce
- Department of Precision Medicine, Radiology and Radiotherapy, University of Campania Luigi Vanvitelli. Piazza Miraglia, Naples Italy
| | - Giovanni Mazzei
- School of Medicine, University St. Kliment Ohridski, Sofia, Bulgaria
| | - Olimpia Fabozzi
- Department of Radiology, SG Moscati Hospital, Aversa Caserta, Italy
| | - Vincenzo Parlato
- Department of Precision Medicine, Radiology and Radiotherapy, University of Campania Luigi Vanvitelli. Piazza Miraglia, Naples Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, Radiology and Radiotherapy, University of Campania Luigi Vanvitelli. Piazza Miraglia, Naples Italy
| | - Sabrina Giovine
- Department of Radiology, SG Moscati Hospital, Aversa Caserta, Italy
| |
Collapse
|
19
|
Monahan K. Intimate Partner Violence, Traumatic Brain Injury, and Social Work: Moving Forward. SOCIAL WORK 2018; 63:179-181. [PMID: 29409018 DOI: 10.1093/sw/swy005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/12/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Kathleen Monahan
- Kathleen Monahan, DSW, LCSW, is associate professor, School of Social Welfare, Stony Brook University, 10 Bobilin Lane, Rocky Point, NY 11778; e-mail:
| |
Collapse
|
20
|
Intimate partner violence against women, circumstances of aggressions and oral-maxillofacial traumas: A medical-legal and forensic approach. Leg Med (Tokyo) 2018; 31:1-6. [DOI: 10.1016/j.legalmed.2017.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 11/28/2017] [Accepted: 12/02/2017] [Indexed: 11/20/2022]
|
21
|
Monahan K, Goldfine A, Biegon A. Traumatic brain injuries in victims of intimate partner violence: an underappreciated source of neurological morbidity. FUTURE NEUROLOGY 2017. [DOI: 10.2217/fnl-2017-0026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Kathleen Monahan
- School of Social Welfare, Stony Brook University, HSC, Nicolls Rd, Stony Brook, NY 11794-8231, USA
| | - Andrew Goldfine
- School of Medicine, Stony Brook University, HSC, Nicolls Rd, Stony Brook, NY 11794-8121, USA
| | - Anat Biegon
- School of Medicine, Stony Brook University, Stony Brook, NY 11794-2565, USA
| |
Collapse
|