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Pediatric Radiology
Published in: Pediatric Radiology 3/2018

01-03-2018 | Commentary

Distinguishing child abuse fractures from rickets

Author: Alan E. Oestreich

Published in: Pediatric Radiology | Issue 3/2018

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Excerpt

The keystone of distinguishing suspected child abuse on radiographs from manifestations of rickets, including healing rickets, is looking at bones other than that bone suspected of rickets, as well as carefully perusing the bone under suspicion. Understanding the metaphyseal collar and the zone of provisional calcification as part of the normal, non-rachitic, tubular bone metaphyses should help distinguish between rickets and changes related to fracture. …
Literature
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Ayoub DM, Hyman C, Cohen M et al (2014) A critical review of the classic metaphyseal lesion: traumatic or metabolic? AJR Am J Roentgenol 202:185–196CrossRefPubMed
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Oestreich AE (2015) Concave distal end of ulna metaphysis alone is not a sign of rickets. Pediatr Radiol 45:998–1000CrossRefPubMed
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Kepron C, Pollanen MS (2015) Rickets or abuse? A histologic comparison of rickets and child abuse-related fractures. Forensic Sci Med Pathol 11:78–87CrossRefPubMed
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Laval-Jeantet M, Balmain N, Juster M et al (1968) Les rapports de la virole périchondrale et du cartilage en croissance normale et pathologique [Relations of the perichondral ring to the cartilage in normal and in pathological growth]. Ann Radiol 11:327–335
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Russell JGB, Hill LF (1974) True fetal rickets. Brit. J Radiol 47:732–734CrossRef
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Paterson CR, Ayoub D (2015) Congenital rickets due to vitamin D deficiency in the mothers. Clin Nutr 34:793–798CrossRefPubMed
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Oestreich AE (2004) The acrophysis: a unifying concept for understanding enchondral bone growth and its disorders. II. Abnormal growth. Skelet Radiol 33:119–128CrossRef
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Holm I, Perez-Rosello JM (2015) Disorders of calcium and phosphorus metabolism. In: Kleinman PK (ed) Diagnostic imaging of child abuse, 3rd edn. Cambridge University Press, Cambridge, pp 240–253CrossRef
Metadata
Title
Distinguishing child abuse fractures from rickets
Author
Alan E. Oestreich
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 3/2018
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-017-4037-0

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