Non-accidental injury

Case contributed by Dr Alborz Jahangiri

Presentation

1 year old child with inability to weight bear on the left leg. Parents report falling into a ditch some time ago.

Patient Data

Age: 1
Gender: Female
X-ray

The hip joints are enlocated. There is a subtle lucency in the left capital femoral metaphysis seen on the frog leg images suspicious for a metaphyseal fracture. There is an oblique lucency in the midshaft of the fibula with suspected periosteal reaction and slight endosteal sclerosis.

The physes and metaphyses of knee and ankle appear within normal limits.The joint space is preserved. The articular margins are smooth. No focal lytic or sclerotic lesion is identified. The bony pelvis is otherwise unremarkable. 

Case Discussion

There are appearances of a suspected left femoral metaphyseal Salter Harris fracture and a fibular fracture. The presence of two fractures of different ages raises the differential of non accidental injury.

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Case information

rID: 45807
Case created: 9th Jun 2016
Last edited: 12th Jun 2016
Inclusion in quiz mode: Included

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