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Child Abuse, Other Fractures
Michael R. Aquino, MD, MHSc; A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Imaging

    TERMINOLOGY

    • Synonyms

      • Nonaccidental trauma (NAT), battered child syndrome

    IMAGING

    • General Features

      • High-Specificity Fractures

        • Moderate-Specificity Fractures

          • Low-Specificity Fractures

            • Dating Fractures

              DIFFERENTIAL DIAGNOSIS

                PATHOLOGY

                • General Features

                  CLINICAL ISSUES

                  • Presentation

                    • Demographics

                      • Natural History & Prognosis

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            • Reporting Tips

                              Selected References

                              1. Kleinman PK: Diagnostic imaging of child abuse. Cambridge, United Kingdom New York: Cambridge University Press, 2015
                              2. Supakul N et al: Distal humeral epiphyseal separation in young children: an often-missed fracture-radiographic signs and ultrasound confirmatory diagnosis. AJR Am J Roentgenol. 204(2):W192-8, 2015
                              3. Bixby SD et al: Ischial apophyseal fracture in an abused infant. Pediatr Radiol. 44(9):1175-8, 2014
                              4. Walters MM et al: Healing patterns of clavicular birth injuries as a guide to fracture dating in cases of possible infant abuse. Pediatr Radiol. 44(10):1224-9, 2014
                              5. Barber I et al: Prevalence and relevance of pediatric spinal fractures in suspected child abuse. Pediatr Radiol. 43(11):1507-15, 2013
                              6. Kleinman PK et al: Yield of radiographic skeletal surveys for detection of hand, foot, and spine fractures in suspected child abuse. AJR Am J Roentgenol. 200(3):641-4, 2013
                              7. Prosser I et al: A timetable for the radiologic features of fracture healing in young children. AJR Am J Roentgenol. 198(5):1014-20, 2012
                              8. Kemp AM et al: What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review. Arch Dis Child. 95(5):355-60, 2010
                              9. Loder RT et al: Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids' inpatient database. J Pediatr Orthop. 2007 Jun;27(4):421-6. Erratum in: J Pediatr Orthop. 28(6):699, 2008
                              10. Hechter S et al: Sternal fractures as a manifestation of abusive injury in children. Pediatr Radiol. 32(12):902-6, 2002
                              11. Nimkin K et al: Fractures of the hands and feet in child abuse: imaging and pathologic features. Radiology. 203(1):233-6, 1997
                              12. Nimkin K et al: Distal humeral physeal injuries in child abuse: MR imaging and ultrasonography findings. Pediatr Radiol. 25(7):562-5, 1995
                              13. Kleinman PK et al: Vertebral body fractures in child abuse. Radiologic-histopathologic correlates. Invest Radiol. 27(9):715-22, 1992
                              14. Kleinman PK et al: Avulsion of the spinous processes caused by infant abuse. Radiology. 151(2):389-91, 1984
                              15. Merten DF et al: Occult humeral epiphyseal fracture in battered infants. Pediatr Radiol. 10(3):151-4, 1981
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Imaging

                                TERMINOLOGY

                                • Synonyms

                                  • Nonaccidental trauma (NAT), battered child syndrome

                                IMAGING

                                • General Features

                                  • High-Specificity Fractures

                                    • Moderate-Specificity Fractures

                                      • Low-Specificity Fractures

                                        • Dating Fractures

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      DIAGNOSTIC CHECKLIST

                                                      • Consider

                                                        • Reporting Tips

                                                          Selected References

                                                          1. Kleinman PK: Diagnostic imaging of child abuse. Cambridge, United Kingdom New York: Cambridge University Press, 2015
                                                          2. Supakul N et al: Distal humeral epiphyseal separation in young children: an often-missed fracture-radiographic signs and ultrasound confirmatory diagnosis. AJR Am J Roentgenol. 204(2):W192-8, 2015
                                                          3. Bixby SD et al: Ischial apophyseal fracture in an abused infant. Pediatr Radiol. 44(9):1175-8, 2014
                                                          4. Walters MM et al: Healing patterns of clavicular birth injuries as a guide to fracture dating in cases of possible infant abuse. Pediatr Radiol. 44(10):1224-9, 2014
                                                          5. Barber I et al: Prevalence and relevance of pediatric spinal fractures in suspected child abuse. Pediatr Radiol. 43(11):1507-15, 2013
                                                          6. Kleinman PK et al: Yield of radiographic skeletal surveys for detection of hand, foot, and spine fractures in suspected child abuse. AJR Am J Roentgenol. 200(3):641-4, 2013
                                                          7. Prosser I et al: A timetable for the radiologic features of fracture healing in young children. AJR Am J Roentgenol. 198(5):1014-20, 2012
                                                          8. Kemp AM et al: What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review. Arch Dis Child. 95(5):355-60, 2010
                                                          9. Loder RT et al: Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids' inpatient database. J Pediatr Orthop. 2007 Jun;27(4):421-6. Erratum in: J Pediatr Orthop. 28(6):699, 2008
                                                          10. Hechter S et al: Sternal fractures as a manifestation of abusive injury in children. Pediatr Radiol. 32(12):902-6, 2002
                                                          11. Nimkin K et al: Fractures of the hands and feet in child abuse: imaging and pathologic features. Radiology. 203(1):233-6, 1997
                                                          12. Nimkin K et al: Distal humeral physeal injuries in child abuse: MR imaging and ultrasonography findings. Pediatr Radiol. 25(7):562-5, 1995
                                                          13. Kleinman PK et al: Vertebral body fractures in child abuse. Radiologic-histopathologic correlates. Invest Radiol. 27(9):715-22, 1992
                                                          14. Kleinman PK et al: Avulsion of the spinous processes caused by infant abuse. Radiology. 151(2):389-91, 1984
                                                          15. Merten DF et al: Occult humeral epiphyseal fracture in battered infants. Pediatr Radiol. 10(3):151-4, 1981