Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Case 101 - Non-accidental trauma: skeletal injuries
from Section 8 - Pediatrics
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Summary
Imaging description
Skeletal injuries that have a high predictive value for non-accidental trauma (NAT) include metaphyseal corner fractures, posterior rib fractures, scapula fractures, and spinous process fractures. These bones are usually difficult to break. Humeral and femoral shaft fractures, particularly distal shaft fractures, are the most common long bone fractures in NAT and should be treated with suspicion in children less than three years [1–3]. Moreover, the presence of multiple fractures of different ages is highly suspicious for NAT.
Metaphyseal corner fractures of NAT, also referred to as “metaphyseal lesions” are avulsion fractures of an arcuate metaphyseal fragment passing through the primary spongiosa overlying the lucent epiphyseal cartilage. This results in irregularity and fragmentation of the metaphysis (Figure 101.1). When a classic metaphyseal lesion is suspected, two radiographic projections of the affected joint are required to avoid confusion with mild physiologic irregularity of the metaphysis or chronic stress such as in malignancy [4]. Metaphyseal fractures of child abuse are most commonly encountered around the knee or elbow. They are also discussed in Case 99.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 371 - 374Publisher: Cambridge University PressPrint publication year: 2013