Presentation
This toddler was brought to the ED with irritability.
Patient Data
Age: 1-2 years
Gender: Male
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There is a subtle fracture at the anterior aspect of the distal left tibia.
From the case:
Metaphyseal corner fracture (child abuse)
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Magnified key image of the fracture.
Case Discussion
Appearances are consistent with a metaphyseal corner fracture.
In this age group, a metaphyseal injury is not in keeping with accidental trauma. A metaphyseal corner fracture is highly specific for non-accidental injury in a non-ambulant infant. A notable exception is obstetric trauma during difficult delivery.
In this case, there were no other radiological features of NAI.
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