Value of additional lateral radiographs in paediatric skeletal surveys for suspected physical abuse

Meshaka, R.; Garbera, David; Arthurs, Owen J.; Shelmerdine, Susan C.

doi:10.1016/j.crad.2021.09.019

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Owing to their scarcity, the diagnosis of pediatric ankle fractures mandates discernment, necessitating a nuanced differentiation between accidental trauma, potential abuse, or alternative non-malicious etiologies [ 10 , 11 ]. Clinicians frequently encounter fractures attributed to the exuberant proclivities inherent in childhood activities.…”

Section: Introductionmentioning

confidence: 99%

“…The elucidation of diagnostic intricacies is facilitated by the congruence among the reported incident; clinical presentation characterized by edema, pain, and constrained mobility; and radiological corroboration aligning with anticipated outcomes. The complexity is further compounded when the suspicion of child abuse arises, marked by injuries bereft of plausible explanations or exhibiting incongruities [ 11 ]. Classic metaphyseal lesions or atypical fracture configurations may serve as harbingers of potential abuse, warranting a comprehensive investigative appraisal.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Ankle Fractures: Successful Remodeling and Restoration Through Comprehensive Diagnosis and Conservative Management in a Diverse Context

Pechlivanidou,

Constantas,

Kallaras

et al. 2024

Cureus

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Diagnosing toddler ankle fractures, especially those that affect several bones, can be difficult. The infrequency of such complex injuries, particularly in household environments, emphasizes the importance of increased awareness in diagnosing and managing these types of injuries. We present a compelling case study of a 20-month-old toddler of a low socioeconomic background who sustained fractures in the ankle, calcaneus, tibia, and fibula after being trapped under furniture. The diagnostic process involved trauma guidelines, radiographic assessments, and axial CT scans. Conservative management, including an eight-week plaster cast, was chosen based on the careful consideration of the child's age, the nature of the fracture, and the absence of immediate surgical indications. The follow-up period involved radiographic assessments, as well as repeated regular clinical examinations, revealing consistent alignment and the absence of complications. The successful outcome underscores the importance of a comprehensive diagnostic approach, thoughtful treatment planning, and meticulous follow-up. Individualized care, considering both clinical and socioeconomic factors, proved crucial for optimal outcomes in pediatric orthopedics. The case contributes valuable insights into the evolving landscape of early childhood orthopedics, emphasizing the need for a discerning approach to diagnosing and managing complex fractures in this population. Conservative treatment could significantly assist when absolute surgical indications are lacking both in cases of minimal resources where multiple operations are not plausible and when the patient's social history raises awareness.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%