Child Abuse Pediatricians Destroying Families by Diagnosing “Abuse” When Medical Condition is Rickets
by Allie Parker
Health Impact News
presented here in two parts but complete story at a glance here
The method of diagnosing rickets in infants has been proven to be incorrect, yet it is still considered the standard practice used by child abuse pediatricians to diagnose abuse in infants and children with blatant disregard for laboratory testing showing a vitamin D deficiency or other metabolic bone disease.
The diagnosis of rickets in infants is left solely on a radiologist, despite blood tests showing deficiency, insufficiency, and efficient vitamin D levels.
X-rays are the standard practice or “gold standard” of diagnosing rickets in infants. Rickets is a condition that affects bone development in children. It causes bone pain, poor growth and soft, weak bones that can lead to bone deformities and fractures.
Adults can experience a similar condition, which is known as osteomalacia or soft bones [1].
The dual-energy x-ray absorptiometry (DXA and DEXA scan) is the preferred technology for measuring bone mineralization, because of its ease of use, low radiation exposure, and ability to measure bone mineral density at both the hip and spine, DEXA is the most commonly used technique to measure bone mineral density [2].
The American Academy of Pediatrics: Committee on Child Abuse and Neglect (AAPCCAN) has issued guidelines for the evaluation of children with multiple unexplained fractures, concluding they are almost always due to abuse.
However, common sense questions still need answering:
- Why would abusive parents repeatedly seek medical care for the infant they abused?
- Why would chest trauma severe enough to fracture ribs not also results in lung damage?
- Why wouldn’t blunt chest trauma cause some inwardly angulated rib fractures instead of all perfectly aligned fracture ends?
- Wouldn’t parents who beat their infant severely enough to cause multiple fractures show evidence of psychopathology?
- Do infants who are beaten severely enough to cause multiple fractures show fear in the presence of the abuser?
- How often do the eyewitnesses to parental/infant interactions report the parents were concerned and loving parents? [3]
It’s shocking what the studies show in regards to radiologists looking at the same images and coming up with two different interpretations.
For example, two radiology professors at Stanford University diagnosed multiple fractures due to rickets on several infants, and concluded that there is a “national and international epidemic” of infantile rickets [4].
In another study, two board certified radiologists examined the same x-rays and diagnosed child abuse [5].
Another study of 41 infants who died due to SID’s found that only 7% of bone biopsy-proven rickets was picked up by pediatric radiologists [6,7].
In a more recent study (2014), a group of 52 children who died of various causes reported histological rickets in 10 children (19%) with vitamin D levels less that 10 ng/ml but pre-morbid x-rays missed the rickets 70% of the time.
In the same study, eight infants with vitamin D levels between 10-20 ng/ml had histological rickets, but pre-morbid radiology was normal in 100% of the infants, three of which had fractures. Again, radiologists missed biopsy-proven rickets more than 80% of the time [8].
Bone biopsy and (DEXA) scans are still not considered the gold standard when it comes to diagnosing rickets in children. A current textbook of orthopedic pathology states, “In subtle cases absolute certainty requires tissue examination.”
The author goes on to say, “a bone biopsy is indicated in every patient in whom a cause of fracture is unexplained.” (p.127) [9]
It’s a shame child abuse pediatricians don’t have the same train of thought, which is to be absolutely certain.
They aren’t diagnosing a disease, but a crime. A crime which, if founded, will result in the destruction of a family. The parents will lose parental rights of their child, who is often adopted out to strangers, and also sends one or both of the parents to jail. Not to mention the damage that occurs to the child, who is losing loving parents.
Despite all this knowledge, bone biopsies and even (DEXA) scans are rarely done when children present to a children’s hospital with unexplained fractures.
Instead, the hospital goes into “non-accidental trauma” auto-pilot, ordering tests that are not needed, subjecting the infants to unnecessary radiation exposure.
They are dilating the infant’s eyes to check for retinal hemorrhage when no neurological signs, symptoms or injuries have been noted.
Even when all of these tests come back negative, and all they have are fractures, they still only rely on the radiologist’s conclusion, which is any unexplained fracture is “highly specific” for abuse.
Even when a parent or guardian has a true and reasonable reason for the fracture, the child abuse pediatrician claims the “type” of fracture does not provide an adequate mechanism for the fracture.
A simple (DEXA) scan, which most children’s hospitals have on site, can be done to check for bone mineralization, and still, child abuse pediatricians disregard blood work suggestive of rickets simply because the x-rays do not confirm rickets or any metabolic bone disease.
Instead, they choose to accuse the parents of a crime. Some stating it is “diagnostic of abuse” which is an extreme amount of medical certainty.
Once the accusation of child abuse is made by a child abuse pediatrician, the family is guilty. Even though the burden of proof is on the prosecution in the civil case, the family is still the one tasked with finding and paying an attorney, if they are able, and finding and paying expert witnesses to review their case and testify on their behalf.
This doesn’t include the fact their children have been taken away from them, often put in foster care, and the parents are now on the central registry of child abusers. See:
