By B G Brogdon; Tor Shwayder; Jamie Elifritz
''Of all young ones suggested to baby protecting prone for suspected maltreatment in any shape, the proportion of substantiated situations of actual abuse really is kind of small. there are various dermatological and radiologically demonstrable musculoskeletal lesions which were, or might be fallacious for, intentional actual abuse via the green or under-educated observer. This atlas illustrates the vintage manifestations of actual abuse by way of dermatological and radiological exam as a regular opposed to which the mimickers of actual abuse may be in comparison. the place acceptable, the authors offer pertinent ancient, actual and laboratory details in help of the diagnosis''--Provided through publisher. Read more...
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Additional info for Child abuse and its mimics in skin and bone
2 Torus or buckle fractures of the distal radius. 3 Greenstick (incomplete fracture of the ulna at the junction of the upper and middle one-thirds). Only the anterior cortex is disrupted. The posterior cortex (arrow) is intact. Normal radius. 4 (a) Undisplaced transverse fracture of the ulna (arrow). (b) Subtle oblique fracture of the tibia (arrows). (c) Healing spiral fracture of the humerus (arrows). Notice the subperiosteal new bone surrounding and stabilizing the entire shaft of the bone. (d) Butterfly fracture of the midshaft of the tibia.
29) but may also be accidental, as by a fall upon an object or in bones weakened by metabolic processes. Musculoskeletal Trauma in Infants and Children: Accidental or Inflicted? 28 Healing first rib fracture appears to be developing a nonunion. Abuse likely at this location. 29 Unilateral focal rib fractures (arrow) probably caused by a direct blow. 25 Cardiopulmonary resuscitation is an extraordinarily unlikely cause for rib fracture in children. Maguire and co-workers26 found anterior rib fractures in only 3 of 923 children 34 Child Abuse and Its Mimics in Skin and Bone who underwent CPR rendered by both trained and untrained persons.
There is some periosteal reaction along the proximal femoral shaft first thought to be post-traumatic, but the joint became infected. (c) Blighted development of the proximal epiphysis. 36 Subluxation of the left hip due to intracapsular blood or effusion in a child who had massive trauma elsewhere. This child probably was swung by this extremity. Compare with the normal right hip. by an extended arm. 33 It is easily diagnosed upon physical examination and rarely requires imaging (ultrasonography will do nicely).