Non-accidental injury

Case contributed by Rad_doc


1 week of fussiness. Child's parent also notes some shortness of breath.

Patient Data

Age: 1 year

Multiple left-sided rib fractures. Left pleural effusion may represent hemothorax. 


Multiple fractures as outlined below:

  • left arm radiograph shows a buckle fracture of the distal radius, oblique fracture through distal ulnar diaphysis (the rib fractures are also visible on this radiograph)
  • skull radiograph shows a cortical step on the left and linear lucencies bilaterally concerning for fracture, most likely of the parietal bones
  • lower limb radiograph shows metaphyseal corner fractures of the distal femurs

Case Discussion

Radiologists are often the first to suspect non-accidental injury (a.k.a. child abuse) when radiographs are obtained for a myriad of reasons. Thus rapid recognition and clear communication of these specific injury patterns are essential to prevent further neglect and injury. 

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