By Katherine Anderson
Radiologists play a key role in detecting trauma and substance-related complications, particularly in undisclosed cases, according to research presented Tuesday.
“Patients experiencing intimate partner violence (IPV) often present repeatedly with injuries of varying ages and severities, while individuals with opioid use disorder (OUD) undergo frequent imaging for pain or trauma-related complications,” said study author Jade Iwasaka-Neder, MD, MPH, a research fellow in the Trauma Imaging Research and Innovation Center (TIRIC) and the Department of Radiology at Brigham and Women’s Hospital in Boston.
“However, these patterns are often documented in isolation, leading to missed opportunities for early detection and intervention. I was inspired to conduct this study by Bharti Khurana, MD, MBA, principal investigator, founder and director of TIRIC, and associate professor of radiology at Harvard Medical School in Boston, who first recognized this pattern while reviewing emergency imaging studies.”
Despite the wealth of radiology data on these vulnerable patient populations, the connection between IPV and OUD has not been fully explored.
In a retrospective study, Dr. Iwasaka-Neder and colleagues analyzed the lifetime radiology reports of female patients who reported IPV between 2013 and 2018 and those who didn’t. ICD-9/10 codes were used to identify OUD status, resulting in four patient groups: those reporting both IPV and OUD, IPV only, OUD only and neither condition.
Patients with both IPV and OUD underwent the most imaging, sustained more radiologically evident injuries and had higher rates of severe injuries.
Distinct injury patterns emerged across the different patient groups: IPV-only patients were more likely to have injuries to the face, neck and head, while OUD-only patients more often had injuries involving the lumbar spine, chest and thoracic spine.
“When both were present, the risk and severity of injuries were amplified—showing how these two conditions compound each other and create a cycle of vulnerability,” Dr. Iwasaka-Neder said.
Injuries to the lumbar spine, chest and abdomen also emerged as strong predictors of OUD among IPV survivors.
“Recognizing these patterns can help clinicians think beyond the injury itself—screening for opioid misuse earlier, offering more careful pain management and connecting patients with social or behavioral support services,” she said.
Those in the IPV and OUD group received the highest number of scans, undergoing ten times more CTs than patients without either condition.
“Clinicians should be mindful of cumulative exposure and consider when repeat imaging is truly necessary,” Dr. Iwasaka-Neder stressed. “It’s really about balancing thorough diagnostic care with thoughtful, patient-centered use of resources—because these patients often come back to the hospital many times, and every scan, every encounter, is an opportunity to intervene and support them differently.”
Dr. Iwasaka-Neder hopes that insights from this study demonstrate how radiology data can reveal hidden clinical patterns across vulnerable patient groups and enable earlier recognition of those at risk.
“What makes this work special is that we’re using systematic radiology data—something that’s often underused in public health research—to uncover patterns that can actually help clinicians in real time,” Dr. Iwasaka-Neder said. “By identifying which types of injuries are more common among IPV survivors with OUD, we hope to help providers recognize these risks earlier, support safer pain management and ultimately improve care for a very vulnerable group of patients.”
Access the presentation, “Radiological Insights Into the Intersection of Intimate Partner Violence and Opioid Use Disorder,” (T3-SSER01-6) on demand at RSNA.org/MeetingCentral
© 2025 RSNA.
The RSNA 2025 Daily Bulletin is the official publication of the 110th Scientific Assembly and Annual Meeting of the Radiological Society of North America. Published online Sunday, November 30 — Thursday, December 4.
The RSNA 2025 Daily Bulletin is owned and published by the Radiological Society of North America, Inc., 820 Jorie Blvd., Suite 200, Oak Brook, IL 60523.
