President continued from p. 2
well as to promote awareness of available scholarship opportunities. These activities are financed by The
Roentgen Fund; thus participation by all ARRS members
is encouraged. We look for ward to your contributions (tax
deductible, of course) and are in the process of developing an estate gifting mechanism.
All of these goals should be completed within the next one-to-five years and at the end of this period we will critically reassess
them. We are currently re-gauging several popular activities of
our annual meeting (Case-Based Review, Categorical Course,
We strive to keep our content relevant
and enticing to our members, thus we are
constantly re-evaluating our meetings and
publications, and making adjustments to keep
them fresh and up to date.
etc.) to match new trends, knowledge, and certification requirements. With our new strategies and activities, we hope to become indispensable in your life and future.n
As many as 10% of older U.S. adults experience elder mistreatment each year, and evidence suggests that victims have
dramatically increased mortality and morbidity, according to
the AJR article.
Though extreme cases of elder abuse are usually obvious, more
subtle cases require a vigilant health care team. Geriatric patients,
particularly those with acute injuries, commonly undergo radiographic imaging as part of their medical evaluation, so radiologists
may be well-positioned to raise suspicion for mistreatment.
“There’s a stereotype that elder abuse incidents are more
likely to occur in victims who live in nursing homes—but that’s
not always true,” Murphy said. “Sometimes this happens when
the elderly are being taken care of by family or other care takers and the patient is afraid to speak up out of fear that he or she
will be placed in a nursing home. In some ERs, there are geriatric nurses who look for these types of injuries and know how to
talk to the patients.”
None of the 19 participants interviewed for the study reported identifying elder abuse on imaging during independent practice or training, despite a total of 159 years of independent
practice and 80 years of training.
Only two participants who reported formal or information
training in elder abuse detection with an attending emergency
radiologist, reported having seen a brief presentation at a national radiology conference, and one resident reported attending a
lecture about identifying elder abuse.
All 19 participants reported believing that they missed cases of
elder abuse in their practice, emphasizing that they do not typically
consider it as a diagnostic possibility when evaluating radiographs.
Elder Abuse continued from p. 3
Given that radiologists do not evaluate patients, participants
highlighted the importance of improved collaboration with treating clinicians in identifying elder abuse. They said that learning
about suspicions from the treating provider about potential elder
abuse would significantly alter their analysis of radiographs.
Though participants reported routinely receiving requests from
treating clinicians to evaluate images for potential child abuse, even
experienced radiologists reported never having received a request
to assess images for evidence suggestive of elder abuse.
Radiologists interviewed were able to identify radiographic
findings that may be suggestive of elder abuse and focused on
improved collaboration with treating providers as critical for improved identification. Authors indicated that additional research
is needed to define pathognomonic injury patterns and to explore how to empower diagnostic radiologists to incorporate detection into their practice.n
1. Murphy K, Waa S, Jaffer H, Sauter A, Chan A. A literature review of findings in
physical elder abuse. Can Assoc Radiol J 2013; 64: 10–14
Geriatric patients, particularly those with acute
injuries, commonly undergo radiographic
imaging as part of their medical evaluation, so
radiologists may be well-positioned to raise
suspicion for mistreatment.
What they said…
Responses from the study participants
• “With child abuse, often the referring physician will let
us know they suspect child abuse. I have yet to have
anyone tell me (in an 18-year career) that they suspect
• “If there was some way for the referring clinician to alert
us that maybe that’s (elder abuse), one of their differen-
tial considerations, without necessarily having to put it
in the EMR automatically or put it in the indication, that
would be helpful.”
• “The ED does not usually provide us with a good
history…I may just get ‘fall’ or ‘found down’…I don’t
know if they were found down in a nursing home, in
their own home, or…in the street.”
• “I don’t think we ever get any information other than
somebody fell in a nursing home…”