One of the major problems we pediatric radiologists encounter in our effort to diagnose accurately child abuse and to have that diagnosis lead to appropriate care and protection of the child is with a group of professionals who deny the possibility of abuse in the face of radiologic evidence of abuse – and then they testify as to their opinion.

Unfortunately, legal proceedings in questions of child abuse resemble to some extent athletic contests in which each “team” uses any available tactic to achieve victory. We are dealing with the health and well-being of the child, which should not be so treated. It is agreed that whenever possible, the home environment should be preferred to removal from the home, but only if that environment is sufficiently safe for the child. Radiographic findings strongly suggestive of abuse are debated by the zealous abuse deniers in opposition to the majority of pediatric radiologists. For example, fractures are attributed to “rickets ” in the absence of any radiographic findings of rickets.

The cadre of “abuse deniers” is well organized. Indeed, they apparently have access to pediatric subspecialists, who share their views and are willing to so testify. It seems that the same names of testifiers that child abuse was not present are repeatedly seen. When they serve as teachers in medical school, the false doctrines may be passed on to new generations of practitioners.

The situation has been forcefully stated in Dr. Peter J Strouse’s editorial in Pediatric Radiology [1]. He introduces the effective new term “denialist ” for those deniers.