D., Ohman-Strickland, P., Mehta, S., & Hume, E. A critical review of the classic metaphyseal lesion: Traumatic or metabolic? American Journal of Roentgenology, 202(1), 185–196.īaldwin, K. Pediatric isolated thoracic and/or lumbar transverse and spinous process fractures. The Journal of Pediatrics, 154–159, e2.Īkinpelu, B., Zuckerman, S., Gannon, S., Westrick, A., Shannon, C., & Naftel, R. Classic metaphyseal lesions among victims of abuse. Retrieved from Īdamsbaum, C., De Boissieu, P., Teglas, J. KeywordsĪCR–SPR Practice Parameter for Skeletal Surveys in Children. Finally, this chapter will guide the healthcare provider through the child abuse evaluation, including the importance of having a pediatric radiologist involved, follow-up skeletal surveys, and the necessity of communication between the general pediatrician, the child abuse pediatrician, and the pediatric radiologist. This chapter will explore the medical evaluation needed when a child presents with an injury suspicious for abuse, including the requisite history, physical exam, laboratory studies, and radiologic imaging. It is also important to evaluate theories of fracture causation that healthcare providers may encounter in the literature or from other healthcare providers. This chapter also examines syndromes, metabolic disorders, and diseases that can affect bone health and lead to fractures that could be mistaken for non-accidental trauma. It will explore the mechanical forces necessary to create different types of fractures, equipping the reader with knowledge required to analyze history plausibility as it relates to the fracture in question. It will discuss various fractures and their specificity for abuse. This chapter provides a fundamental foundation for bone physiology and fracture pathology. In order to do so, one must have a solid knowledge of the basics of bone structure and health. It is imperative that all healthcare professionals possess a good understanding of fractures that are more likely to be abusive in nature. Child abuse was the fourth leading cause of death among children 1–4 years of age in 2016 (Heron 2018), and fractures are the second most common type of physical injury due to child abuse (Flaherty et al.
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