A new role for imaging in the diagnosis of physical elder abuse: results of a qualitative study with radiologists and frontline providers

ABSTRACT

Pediatric radiologists play a key role in the detection of child abuse through the identification of characteristic injury patterns. Emergency radiologists have the potential to play an equally important role in the detection of elder physical abuse; however, they currently play little to no part in this effort. We examine the reasons behind this limited role, and potential strategies to expand it, by interviewing attending faculty from Emergency Radiology, Geriatrics, Emergency Medicine, Pediatric Radiology, and Pediatrics. Our interviews revealed that radiologists’ contribution to elder abuse detection is currently limited by gaps in training, gaps in knowledge about imaging correlates, and gaps in inter-team clinical communication. Specifically, radiographic interpretation of elder trauma is severely restricted by lack of communication between frontline providers and radiologists about patients’ injury mechanism and functional status. Improving this communication and re-conceptualizing ED workflow is critical to expanding and optimizing radiologists’ role in elder abuse detection.

KEYWORDS:

• Elder abuse
• emergency radiology
• elder trauma
• physical abuse
• domestic violence

Conflicts of interest

The authors declare no conflicts of interest.

Additional information

Funding

Tony Rosen’s participation was supported by a GEMSSTAR (Grants for Early Medical and Surgical Subspecialists’ Transition to Aging Research) grant from the National Institute on Aging (R03 AG048109). Tony Rosen is also the recipient of a Jahnigen Career Development Award, supported by the John A. Hartford Foundation, the American Geriatrics Society, the Emergency Medicine Foundation, and the Society of Academic Emergency Medicine.