Imaging of Intimate Partner Violence, From the AJR Special Series on Emergency Radiology.

Intimate partner violence (IPV) is a highly prevalent public health issue with multiple adverse health effects for affected persons. Radiologists are well suited to assess a patient's likelihood of IPV. Recognition of common IPV injury mechanisms and resulting target and defensive injury patterns on imaging, as well as understanding differences in imaging utilization between patients with and without IPV, will aid radiologists in accurate IPV diagnosis. Target injuries often involve the face and neck as a result of blunt trauma or strangulation, whereas defensive injuries often involve the extremity. Awareness of differences in injury patterns resulting from IPV-related and accidental trauma can aid radiologists in detecting a mismatch between the provided clinical history and imaging findings, to support suspicion for IPV. Radiologists should consider all available current and prior imaging in assessing the likelihood of IPV; this process may be aided by machine learning methods. Even if correctly suspecting IPV based on imaging, radiologists face challenges in acting upon that suspicion, including appropriately documenting the findings, without compromising the patient's confidentiality and safety. However, through a multidisciplinary approach with appropriate support mechanisms, radiologists may serve as effective frontline physicians for raising suspicion for IPV.

The Plastic Surgeon's Role in the COVID-19 Crisis: Regarding Domestic Violence.

Pandemics are associated with increased rates of intimate partner violence (IPV). IPV-related physical abuse is most commonly inflicted through craniofacial assault and upper extremity injury. Plastic surgeons are frequently consulted for recommendations in the management of head-and-neck and hand trauma, thereby are uniquely positioned to encounter patients who have experienced IPV. However, IPV training is not routinely offered in surgical education. We provide a review of the increasing prevalence of IPV during the COVID-19 pandemic and its pertinence to plastic surgery consultation in the emergency room. This article aims to increase providers' confidence in recognizing IPV-suspicious injuries and propose an educational, interactive tool for discussing IPV with patients.

Automated processing of social media content for radiologists: applied deep learning to radiological content on twitter during COVID-19 pandemic.

PURPOSE: The purpose of this study was to develop an automated process to analyze multimedia content on Twitter during the COVID-19 outbreak and classify content for radiological significance using deep learning (DL). MATERIALS AND METHODS: Using Twitter search features, all tweets containing keywords from both "radiology" and "COVID-19" were collected for the period January 01, 2020 up to April 24, 2020. The resulting dataset comprised of 8354 tweets. Images were classified as (i) images with text (ii) radiological content (e.g., CT scan snapshots, X-ray images), and (iii) non-medical content like personal images or memes. We trained our deep learning model using Convolutional Neural Networks (CNN) on training dataset of 1040 labeled images drawn from all three classes. We then trained another DL classifier for segmenting images into categories based on human anatomy. All software used is open-source and adapted for this research. The diagnostic performance of the algorithm was assessed by comparing results on a test set of 1885 images. RESULTS: Our analysis shows that in COVID-19 related tweets on radiology, nearly 32% had textual images, another 24% had radiological content, and 44% were not of radiological significance. Our results indicated a 92% accuracy in classifying images originally labeled as chest X-ray or chest CT and a nearly 99% accurate classification of images containing medically relevant text. With larger training dataset and algorithmic tweaks, the accuracy can be further improved. CONCLUSION: Applying DL on rich textual images and other metadata in tweets we can process and classify content for radiological significance in real time.

Exacerbation of Physical Intimate Partner Violence during COVID-19 Pandemic.

Background Intimate partner violence (IPV) is a global social and public health problem, but published literature regarding the exacerbation of physical IPV during the coronavirus disease 2019 (COVID-19) pandemic is lacking. Purpose To assess the incidence, patterns, and severity of injuries in IPV victims during the COVID-19 pandemic in 2020 compared with the prior 3 years. Materials and Methods The demographics, clinical presentation, injuries, and radiologic findings of patients reporting physical abuse arising from IPV during the statewide COVID-19 pandemic between March 11 and May 3, 2020, were compared with data from the same period for the past 3 years. Pearson χ2 and Fisher exact tests were used for analysis. Results A total of 26 victims of physical IPV from 2020 (mean age, 37 years ± 13 [standard deviation]; 25 women) were evaluated and compared with 42 victims of physical IPV (mean age, 41 years ± 15; 40 women) from 2017 to 2019. Although the overall number of patients who reported IPV decreased during the pandemic, the incidence of physical IPV was 1.8 times greater (95% CI: 1.1, 3.0; P = .01). The total number of deep injuries was 28 during 2020 versus 16 from 2017 to 2019; the number of deep injuries per victim was 1.1 during 2020 compared with 0.4 from 2017 to 2019 (P < .001). The incidence of high-risk abuse defined by mechanism was two times greater in 2020 (95% CI: 1.2, 4.7; P = .01). Patients who experienced IPV during the COVID-19 pandemic were more likely to be White; 17 (65%) victims in 2020 were White compared with 11 (26%) in the prior years (P = .007). Conclusion There was a higher incidence and severity of physical intimate partner violence (IPV) during the coronavirus disease 2019 (COVID-19) pandemic compared with the prior 3 years. These results suggest that victims of IPV delayed reaching out to health care services until the late stages of the abuse cycle during the COVID-19 pandemic. © RSNA, 2020.

Addressing intimate partner violence during the COVID-19 pandemic and beyond: how radiologists can make a difference.

Faced with the COVID-19 pandemic, many countries both in Europe and across the world implemented strict stay-at-home orders. These measures helped to slow the spread of the coronavirus but also led to increased mental and physical health issues for the domestically confined population, including an increase in the occurrence of intimate partner violence (IPV) in many countries. IPV is defined as behavior that inflicts physical, psychological, or sexual harm within an intimate relationship. We believe that as radiologists, we can make a difference by being cognizant of this condition, raising an alert when appropriate and treating suspected victims with care and empathy. The aim of this Special Report is to raise awareness of IPV among radiologists and to suggest strategies by which to identify and support IPV victims. KEY POINTS: • The COVID-19 pandemic led to a marked increase in the number of intimate partner violence (IPV) cases, potentially leading to increased emergency department visits and radiological examinations. • Most IPV-related fractures affect the face, fingers, and upper trunk, and may easily be misinterpreted as routine trauma. • Radiologists should carefully review the medical history of suspicious cases, discuss the suspicion with the referring physician, and proactively engage in a private conversation with the patient, pointing to actionable resources for IPV victims.

Intimate partner violence crisis in the COVID-19 pandemic: how can radiologists make a difference?

KEY POINTS: • The COVID-19 crisis resulted in a variety of physical and mental health issues beyond the viral infection itself, as indicated by an increase in domestic violence.• Radiologists should be aware of typical intimate partner violence (IPV) injury patterns, actively ask potential IPV victims about the cause of injury, and be familiar with support systems for IPV victims of their institutions.• Emergency and radiology departments should review their protocols for identifying and supporting IPV victims, and train their staff to work together to implement these measures during and beyond the COVID-19 crisis.