Utility of Skull Radiographs in Infants Undergoing 3D Head CT During Evaluation for Physical Abuse

Comparative study of 158 infants demonstrates that 3D head CT achieves equivalent diagnostic accuracy to skull radiographs for detecting skull fractures in physical abuse evaluations, with superior interrater reliability (κ=0.95 vs 0.65). Findings suggest skull radiographs may be safely omitted when 3D CT is performed, reducing radiation exposure while maintaining diagnostic accuracy.