Presentation
1 week of fussiness. Child's parent also notes some shortness of breath.
Patient Data
Age: 1 year
From the case:
Non-accidental injury
Frontal
Multiple left-sided rib fractures. Left pleural effusion may represent hemothorax.
From the case:
Non-accidental injury
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Left arm
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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