Who is the Silverman of Caffey-Silverman disease?


Sir, I read with interest the letter of Walter Berdon in the July issue of Pediatric Radiology [1]. I must say that I do not share his opinion concerning the confusion in Europe between William Silverman and Fred Silverman. The term “le syndrome de Silverman” is used in Europe and Africa only in the French-language medical literature and only as a synonym of the abused child syndrome. This term was coined in the early 1950s by a group of paediatricians in the Enfants-Malades Hospital in Paris. During the same period, in the same hospital, the paediatric radiologists, under Jacques Lefebvre, were fighting to convince their clinical colleagues of the reality of unrecognized bone injuries, of the battered child syndrome as initially described by Caffey and later by Kempe. When we proposed such a diagnosis we were told we were wrong, having mistaken lesions due to scurvy, rickets or congenital syphilis. For years I wondered why this entity was suddenly accepted and under the name of Silverman. I found the explanation some 20 years ago from a paediatrician colleague who was present when the name of Silverman was adopted for this situation. It was the result of an oral case presentation by Fred Silverman. I have given full details of the story in the foreword I wrote for the second edition of Paul Kleinman’s textbook [2]. Fred Silverman knew that in France his name was used to refer to the radiographic features of unrecognized bone injury. It is probably the reason why in a lecture [3] presented in October 1971 he said, “If an eponymic term is to be considered, I should like to offer that of ‘the syndrome of Ambroise Tardieu’.” I discovered the existence ofAmbroise Tardieu when Fred asked me, in early 1971, to provide him with photographs of the man himself and of the first page of his article on child abuse. Ambroise Tardieu, born in Paris in 1818, was professor of legal medicine in the University of Paris, and in an article published in 1860 [4], reprinted in a book published in the year of his death, 1879, Ambroise Tardieu described all the lesions he had discovered in maltreated children. He introduced the concept of the abused child with not only medical but also demographic, social and psychiatric features. Since Fred’s proposal, each time I have to deliver a lecture, or even a discussion in a case presentation on this topic, to medical students or residents in France I use the term ‘syndrome d’Ambroise Tardieu’ explaining who the man was and why I use his name, but always without result. In the French medical literature, this entity will remain linked to the name of Fred.

DOI: 10.1007/s00247-005-0057-2

Cite this paper

@article{Faur2005WhoIT, title={Who is the Silverman of Caffey-Silverman disease?}, author={Cl{\'e}ment Faur{\'e}}, journal={Pediatric Radiology}, year={2005}, volume={36}, pages={279-279} }