Vitamin D deficiency versus non-accidental trauma: comment on “Rickets or abuse? A histologic comparison of rickets and child abuse-related fractures”

2015 ◽  
Vol 12 (1) ◽  
pp. 119-120 ◽  
Author(s):  
Jordan E. Pinsker ◽  
Conor Kain ◽  
Laura Keller ◽  
Veronica J. Rooks
2016 ◽  
Vol 6 (4) ◽  
pp. 568-590
Author(s):  
Alfredo Walker ◽  
Charis Kepron ◽  
Christopher M. Milroy

Fractures are commonly found in cases regarded as child abuse. The most commonly encountered fractures are to the ribs and the metaphyses. This paper examines the specificity of the classical metaphyseal lesion (CML) and rib fractures as hallmarks of child abuse. Recently, vitamin D deficiency (rickets) has been proposed as an alternative cause for the appearances typically described in CML. The literature in this area is examined. Rib fractures have also been highly associated with child abuse, particularly posterior rib fractures. As well as metabolic bone disease, resuscitation has been examined as a cause of rib fractures in young children. The current literature remains strongly supportive of rib fractures and metaphyseal fractures being indicators of child abuse.


2017 ◽  
pp. 393-395
Author(s):  
Melvin C. Makhni ◽  
Eric C. Makhni ◽  
Eric F. Swart ◽  
Charles S. Day

Author(s):  
Patrick T. Delaplain ◽  
Yigit S. Guner ◽  
Corey J. Rood ◽  
Jeffry Nahmias

Abstract Purpose of Review To provide a resource for providers that may be involved in the diagnosis and management of infant non-accidental trauma (NAT). Recent Findings Infants are more likely to both suffer from physical abuse and die from their subsequent injuries. There are missed opportunities among providers for recognizing sentinel injuries. Minority children are overrepresented in the reporting of child maltreatment, and there is systemic bias in the evaluation and treatment of minority victims of child abuse. Summary Unfortunately, no single, primary preventative intervention has been conclusively shown to reduce the incidence of child maltreatment. Standardized algorithms for NAT screening have been shown to increase the bias-free utilization of NAT evaluations. Every healthcare provider that interacts with children has a responsibility to recognize warning signs of NAT, be able to initiate the evaluation for suspected NAT, and understand their role as a mandatory reporter.


2011 ◽  
Vol 44 (14) ◽  
pp. 22
Author(s):  
WILLIAM E. GOLDEN ◽  
ROBERT H. HOPKINS

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