Identifying Domestic Abuse Patterns Through Radiology Images

A new study presented at the Radiological Society of North American conference has found that imaging patterns can help us do more than determine the cause for particular injuries and abnormalities. Researchers at Brigham and Women’s Hospital (BWH) have determined that certain injury patterns can indicate domestic abuse.

Lead authors Bharti Khurana, MD, assistant director of emergency radiology at BWH and Elizabeth George, MD, a radiology resident at the hospital, evaluated 185 patient files from BWH’s Emergency Department from January 2015 and October 2016 that were referred to the hospital’s domestic abuse and assault programs. Khurana and George assessed and categorized the patient data according to demographics and clinical factors and compared the results to other images and studies from the last five years.

The researchers found that most patients had undergone a median of four imaging exams, and that 151 patients, or 81.6 percent, were victims of some kind of abuse, whether it be physical, emotional, sexual, or all three. The most common types of injuries were soft tissue injuries and extremity fractures commonly affecting the upper limbs, which indicate a possible attempt to prevent some kind of attack. The researchers also found that most victims of intimate partner violence suffered from a range of physical or psychological symptoms that were not connected to the abuse.

"Images do not lie and can sometimes tell us more than the patient in this situation. In the emergency room setting, the priority is to identify acute pathologies, and hence old fractures or fracture-related deformities may not be given sufficient importance. But the presence of old and acute fractures may be pivotal in making the diagnosis of IPV,” said Khurana.