Kieran J. Murphy MD, Presenter: Founder, Active O, LLC Founder, Vexim SA Founder, Jan Medical Corporation Founder, Cognitive Vision, Inc Founder, Kieran Murphy LLC Inventor, Active O, LLC Inventor, Vexim SA Inventor, Jan Medical Corporation Inventor, Cognitive Vision, Inc Inventor, Kieran Murphy LLC Shareholder, Active O, LLC Shareholder, Vexim SA Shareholder, Jan Medical Corporation Shareholder, Cognitive Vision, Inc Shareholder, Kieran Murphy LLC Shareholder, Unigene Laboratories, Inc Shareholder, ETEX Corporation Shareholder, Dfine, Inc Shareholder, Spineology, Inc Shareholder, Theraclion Shareholder, ActiveViews Royalties, Cook Group Incorporated

Sheila Waa MBChB,MMed, Abstract Co-Author: Nothing to Disclose

Amanda Chan, Abstract Co-Author: Nothing to Disclose

Agnes Sauter MA, Abstract Co-Author: Nothing to Disclose

Hussein Jaffer, Abstract Co-Author: Nothing to Disclose

Only 2% of physical elder abuse is reported by clinicians. No elder equivalent of Caffey's syndrome has been described. We reviewed databases and medical literature for reports of radiological evidence, distribution and type of physical injuries in elder abuse with the aim of aiding imaging detection in the clinical setting.

We investigated the Ontario trauma registry, the Ontario Coroner's Office; PubMed, CINAHL, EMBASE databases using phrases such as 'elder abuse', 'geriatric abuse', for reports on the distribution and type of injuries or radiological findings in subjects at or over 60 years of age.

Literature review yielded 1100 injuries from elder abuse. In addition, registries in Ontario yielded 26 cases; 2 confirmed cases of elder abuse; 21 cases of assault by unknown persons in the past five years and a report by the Office of the Chief Coroner of Ontario details three senior mortalities resulting from assaults in long term care facilities. Maxillofacial trauma, dental trauma, subdural haematomas, periorbital and laryngeal trauma, rib fractures and upper extremity injuries were reported. Autopsy studies in elder abuse have shown subdural haemorrhages as causes of mortality in a third of cases(1). These patients were more likely to be socially isolated, demented, depressed, underweight, unkempt, have bed sores and are cared for at home by a financially dependent caregiver with a substance abuse problem. Brain, head and neck injuries have also been found to be more common in abused elderly than accidentally injured elderly(2). (1) Akaza K, et al. Leg Med (Tokyo) 2003. Mar:5(1);7-14 (2) Friedman LS, et al. J Am Geriatr Soc 2011;59:417-422  

We have outlined injuries that are common to physical elder abuse. A risk stratification that integrates the radiological and physical findings within the social context of the injury is needed. We intend to continue our work and investigate the predictiveness of theis pattern prospectively, from common accidental trauma.    

Radiologists should be aware that a pattern of subdural haemorrhages, head and neck, maxillofacial, dental and upper extremity injury are more frequent in the abused elderly (2).

Murphy, K, Waa, S, Chan, A, Sauter, A, Jaffer, H, Review of Radiological Findings in Physical Elder Abuse.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12034257.html