G. Klohs (Halle)  

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3 Months  

N/A  

Leg-Bones  

physical  

3 month-old child, contusions in the thoracic area. Sensitive to touch on both legs, hematomas on the head.  

The characteristic metaphyseal avulsion (mostly at the femur) are explained by the trauma: mostly, the abuser rotates the extremities, particularly often on the thigh. Since the periost is attached tightly in the metaphyseal regions, but cannot expand longitudinally, the rotationally caused periostal injury rips the small bony fragments out of the metaphyseal region. In the area of the diaphysis, the periost detaches, and is initally seen as a double line - and later recognized as calcified subperiostal hemorrhage.  

<- view X-Ray 1

X-Ray 1: The combination of metaphyseal avulsion and periostic detachment due to rotational trauma is typical and specific. (See Pathophysiology)




<- view X-Ray 2

X-Ray 2: Also typical for abuse (but not specific): Serial rib fractures posteriorly or laterally.

 

Total constellation (Consens)  

In this typical constellation, none. Otherwise vitamin C or copper deficiency.  

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Battered child syndrome, child, abuse, child abuse, battered child, contusions, hematomas, extremities, metaphyseal splitting, metaphyseal avulsion, calcified subperiostal hemorrhage, posterior rib fracture, child, childhood, pediatric radiology  

G Klohs. Battered child syndrome (child abuse), case 1. PedRad [serial online] vol 2, no. 3.
URL: www.PedRad.info/?search=20020320212359