Fracture of infants that extends though subphyseal metaphysis & undercuts subperiosteal bone collar (SPBC) peripherally
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Reporting Tips
Selected References
Karmazyn B et al: Accuracy of ultrasound in the diagnosis of classic metaphyseal lesions using radiographs as the gold standard. Pediatr Radiol. 50(8):1123-30, 2020
Karmazyn B et al: Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions. Pediatr Radiol. 50(5):715-25, 2020
Marine MB et al: Ultrasound findings in classic metaphyseal lesions: emphasis on the metaphyseal bone collar and zone of provisional calcification. Pediatr Radiol. 49(7):913-21, 2019
Tsai A et al: Subperiosteal new bone formation with the distal tibial classic metaphyseal lesion: prevalence on radiographic skeletal surveys. Pediatr Radiol. 49(4):551-8, 2019
Tsai A et al: The distal tibial classic metaphyseal lesion: medial versus lateral cortical injury. Pediatr Radiol. 48(7):973-8, 2018
Tsai A et al: Biomechanics of the classic metaphyseal lesion: finite element analysis. Pediatr Radiol. 47(12):1622-30, 2017
Servaes S et al: The etiology and significance of fractures in infants and young children: a critical multidisciplinary review. Pediatr Radiol. 46(5):591-600, 2016
Thackeray JD et al: The classic metaphyseal lesion and traumatic injury. Pediatr Radiol. 46(8):1128-33, 2016
Barber I et al: The yield of high-detail radiographic skeletal surveys in suspected infant abuse. Pediatr Radiol. 45(1):69-80, 2015
Kleinman, PK. Diagnostic imaging of child abuse, 3rd edition. Cambridge University Press, 2015
Perez-Rossello JM et al: Absence of rickets in infants with fatal abusive head trauma and classic metaphyseal lesions. Radiology. 275(3):810-21, 2015
Brown SD et al: SPR Child Abuse Committee Response regarding classic metaphyseal lesion. AJR Am J Roentgenol. 203(2):W232, 2014
Quigley AJ et al: Skeletal survey normal variants, artefacts and commonly misinterpreted findings not to be confused with non-accidental injury. Pediatr Radiol. 44(1):82-93; quiz 79-81, 2014
Tsai A et al: High-resolution CT with histopathological correlates of the classic metaphyseal lesion of infant abuse. Pediatr Radiol. 44(2):124-40, 2014
U.S. Department of Health & Human Services, Administration for Children & Families, Administration on Children, Youth & Families, Children’s Bureau. (2016). Child maltreatment 2014
Dwek JR: The radiographic approach to child abuse. Clin Orthop Relat Res. 469(3):776-89, 2011
Kleinman PK et al: Prevalence of the classic metaphyseal lesion in infants at low versus high risk for abuse. AJR Am J Roentgenol. 197(4):1005-8, 2011
Chapman T et al: Fractures in infants and toddlers with rickets. Pediatr Radiol. 2010 Jul;40(7):1184-9. Epub 2009 Dec 9. Erratum in: Pediatr Radiol. 40(7):1308, 2010
Drubach LA et al: Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology. 255(1):173-81, 2010
Perez-Rossello JM et al: Whole-body MRI in suspected infant abuse. AJR Am J Roentgenol. 195(3):744-50, 2010
Harlan SR et al: Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed? Pediatr Radiol. 39(9):962-8, 2009
Hobbs CJ et al: Nonaccidental trauma: clinical aspects and epidemiology of child abuse. Pediatr Radiol. 39(5):457-60, 2009
Peters ML et al: The presence of bruising associated with fractures. Arch Pediatr Adolesc Med. 162(9):877-81, 2008
Slovis TL et al: Evaluating the data concerning vitamin D insufficiency/deficiency and child abuse. Pediatr Radiol. 38(11):1221-4, 2008
Arkader A et al: Complete distal femoral metaphyseal fractures: a harbinger of child abuse before walking age. J Pediatr Orthop. 27(7):751-3, 2007
Lonergan GJ et al: From the archives of the AFIP. Child abuse: radiologic-pathologic correlation. Radiographics. 23(4):811-45, 2003
Mandelstam SA et al: Complementary use of radiological skeletal survey and bone scintigraphy in detection of bony injuries in suspected child abuse. Arch Dis Child. 88(5):387-90; discussion 387-90, 2003
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the distal femur. AJR Am J Roentgenol. 170(1):43-7, 1998
Kleinman PK et al: A regional approach to classic metaphyseal lesions in abused infants: the distal tibia. AJR Am J Roentgenol. 166(5):1207-12, 1996
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the proximal humerus. AJR Am J Roentgenol. 167(6):1399-403, 1996
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the proximal tibia. AJR Am J Roentgenol. 166(2):421-6, 1996
Kleinman PK et al: Follow-up skeletal surveys in suspected child abuse. AJR Am J Roentgenol. 167(4):893-6, 1996
Kleinman PK et al: Inflicted skeletal injury: a postmortem radiologic-histopathologic study in 31 infants. AJR Am J Roentgenol. 165(3):647-50, 1995
Kleinman PK et al: Relationship of the subperiosteal bone collar to metaphyseal lesions in abused infants. J Bone Joint Surg Am. 77(10):1471-6, 1995
Kemp AM et al: Patterns of skeletal fractures in child abuse: systematic review. BMJ. 2008 Oct 2;337:a1518. doi: 10. PubMed Central PMCID: PMC2563260, 1136
Fracture of infants that extends though subphyseal metaphysis & undercuts subperiosteal bone collar (SPBC) peripherally
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Reporting Tips
Selected References
Karmazyn B et al: Accuracy of ultrasound in the diagnosis of classic metaphyseal lesions using radiographs as the gold standard. Pediatr Radiol. 50(8):1123-30, 2020
Karmazyn B et al: Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions. Pediatr Radiol. 50(5):715-25, 2020
Marine MB et al: Ultrasound findings in classic metaphyseal lesions: emphasis on the metaphyseal bone collar and zone of provisional calcification. Pediatr Radiol. 49(7):913-21, 2019
Tsai A et al: Subperiosteal new bone formation with the distal tibial classic metaphyseal lesion: prevalence on radiographic skeletal surveys. Pediatr Radiol. 49(4):551-8, 2019
Tsai A et al: The distal tibial classic metaphyseal lesion: medial versus lateral cortical injury. Pediatr Radiol. 48(7):973-8, 2018
Tsai A et al: Biomechanics of the classic metaphyseal lesion: finite element analysis. Pediatr Radiol. 47(12):1622-30, 2017
Servaes S et al: The etiology and significance of fractures in infants and young children: a critical multidisciplinary review. Pediatr Radiol. 46(5):591-600, 2016
Thackeray JD et al: The classic metaphyseal lesion and traumatic injury. Pediatr Radiol. 46(8):1128-33, 2016
Barber I et al: The yield of high-detail radiographic skeletal surveys in suspected infant abuse. Pediatr Radiol. 45(1):69-80, 2015
Kleinman, PK. Diagnostic imaging of child abuse, 3rd edition. Cambridge University Press, 2015
Perez-Rossello JM et al: Absence of rickets in infants with fatal abusive head trauma and classic metaphyseal lesions. Radiology. 275(3):810-21, 2015
Brown SD et al: SPR Child Abuse Committee Response regarding classic metaphyseal lesion. AJR Am J Roentgenol. 203(2):W232, 2014
Quigley AJ et al: Skeletal survey normal variants, artefacts and commonly misinterpreted findings not to be confused with non-accidental injury. Pediatr Radiol. 44(1):82-93; quiz 79-81, 2014
Tsai A et al: High-resolution CT with histopathological correlates of the classic metaphyseal lesion of infant abuse. Pediatr Radiol. 44(2):124-40, 2014
U.S. Department of Health & Human Services, Administration for Children & Families, Administration on Children, Youth & Families, Children’s Bureau. (2016). Child maltreatment 2014
Dwek JR: The radiographic approach to child abuse. Clin Orthop Relat Res. 469(3):776-89, 2011
Kleinman PK et al: Prevalence of the classic metaphyseal lesion in infants at low versus high risk for abuse. AJR Am J Roentgenol. 197(4):1005-8, 2011
Chapman T et al: Fractures in infants and toddlers with rickets. Pediatr Radiol. 2010 Jul;40(7):1184-9. Epub 2009 Dec 9. Erratum in: Pediatr Radiol. 40(7):1308, 2010
Drubach LA et al: Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology. 255(1):173-81, 2010
Perez-Rossello JM et al: Whole-body MRI in suspected infant abuse. AJR Am J Roentgenol. 195(3):744-50, 2010
Harlan SR et al: Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed? Pediatr Radiol. 39(9):962-8, 2009
Hobbs CJ et al: Nonaccidental trauma: clinical aspects and epidemiology of child abuse. Pediatr Radiol. 39(5):457-60, 2009
Peters ML et al: The presence of bruising associated with fractures. Arch Pediatr Adolesc Med. 162(9):877-81, 2008
Slovis TL et al: Evaluating the data concerning vitamin D insufficiency/deficiency and child abuse. Pediatr Radiol. 38(11):1221-4, 2008
Arkader A et al: Complete distal femoral metaphyseal fractures: a harbinger of child abuse before walking age. J Pediatr Orthop. 27(7):751-3, 2007
Lonergan GJ et al: From the archives of the AFIP. Child abuse: radiologic-pathologic correlation. Radiographics. 23(4):811-45, 2003
Mandelstam SA et al: Complementary use of radiological skeletal survey and bone scintigraphy in detection of bony injuries in suspected child abuse. Arch Dis Child. 88(5):387-90; discussion 387-90, 2003
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the distal femur. AJR Am J Roentgenol. 170(1):43-7, 1998
Kleinman PK et al: A regional approach to classic metaphyseal lesions in abused infants: the distal tibia. AJR Am J Roentgenol. 166(5):1207-12, 1996
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the proximal humerus. AJR Am J Roentgenol. 167(6):1399-403, 1996
Kleinman PK et al: A regional approach to the classic metaphyseal lesion in abused infants: the proximal tibia. AJR Am J Roentgenol. 166(2):421-6, 1996
Kleinman PK et al: Follow-up skeletal surveys in suspected child abuse. AJR Am J Roentgenol. 167(4):893-6, 1996
Kleinman PK et al: Inflicted skeletal injury: a postmortem radiologic-histopathologic study in 31 infants. AJR Am J Roentgenol. 165(3):647-50, 1995
Kleinman PK et al: Relationship of the subperiosteal bone collar to metaphyseal lesions in abused infants. J Bone Joint Surg Am. 77(10):1471-6, 1995
Kemp AM et al: Patterns of skeletal fractures in child abuse: systematic review. BMJ. 2008 Oct 2;337:a1518. doi: 10. PubMed Central PMCID: PMC2563260, 1136
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