Multiple Metatarsal Fractures in Child Abuse

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 642-643
Author(s):  
Arthur C. Jaffe ◽  
Daniel H. Lasser
Keyword(s):  
Child Abuse ◽  
Medical Practice ◽  
Clinical Findings ◽  
Long Bones ◽  
Skeletal Pathology ◽  
Metatarsal Fractures ◽  
Small Bones

Ever since Caffey's classic description of its clinical findings,1 physicians have been aware of the syndrome of child abuse and its skeletal pathology. Because of the emphasis placed on them by Caffey1 and others,2,3 it is now considered standard medical practice to obtain roentgenograms of the skull, ribs, and long bones as part of the routine evaluation of suspected child abuse. We are reporting an abused infant with multiple metatarsal fractures, an apparently undescribed finding in maltreatment syndromes. We also raise the question of whether or not roentgenographic search for fractures of the small bones of the extremities should be routinely performed.

Ewing's Sarcoma: An Approach to Radiological Diagnosis

1979 ◽  
Vol 65 (3) ◽  
pp. 389-399 ◽  
Author(s):  
Fabrizio Lombardi ◽  
Marco Gasparini ◽  
Cristina Gianni ◽  
Raffaele Petrillo ◽  
John David Tesoro-Tess ◽  
...  
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Primary Site ◽  
Long Bones ◽  
Age Group ◽  
Pediatric Age Group ◽  
Localized Disease ◽  
The Mean ◽  
Small Bones

All the pertinent radiographs of 83 patients with histologically proven Ewing's sarcoma were reviewed. Forty-nine patients were in the pediatric age group, and 34 were adults. The mean age, the symptoms and time from symptoms to diagnosis were evaluated in the 2 groups. The site of primary involvement was in 54 % the long bones, 35 % the flat bones, 8 % the small bones and 3 % extraosseous. For the primary site we considered the diagnostic results of the standard radiographic investigations and in some cases the usefulness of angiography, xeroradiography and telethermography. At presentation we also evaluated the possible diffusion of the disease with standard radiographic surveys (chest and skeletal, including limbs) and with foot lymphography in selected cases. In this way, 57 patients (69 %) were considered to have localized disease. In this group, we also considered the value of the periodic radiographic follow-up, which enabled us to disclose the appearance of metastases (chest 64 %, bone 54 %, lymph nodes 11 %) in 28 cases (49 %). Finally, we made a comparison of the different radiologic and epidemiologic findings between children and adults.

scholarly journals Child Abuse or Bleeding Disorder—An Interdisciplinary Approach

2019 ◽  
Vol 39 (01) ◽  
pp. 028-035
Author(s):  
Werner Streif ◽  
Irmina Watzer-Herberth ◽  
Gabriele Hahn ◽  
Uwe Schmidt ◽  
Ralf Knöfler
Keyword(s):  
Child Abuse ◽  
Child Protection ◽  
Bone Fractures ◽  
Critical Evaluation ◽  
Interdisciplinary Approach ◽  
Clinical Findings ◽  
Bleeding Disorder ◽  
Coagulation Disorder ◽  
Bleeding Tendency ◽  
Concomitant Injuries

AbstractChildren with an unexplained bleeding tendency are frequently referred to a haemostaseologist for further evaluation. Careful standardized history taking and clinical evaluation should allow for distinguishing bleeds after minor injury and trauma which are very common in all children. However, in two groups of children bleeding symptoms may be more significant than expected: those with an underlying coagulation disorder and those who have been subjected to physical child abuse. The coexistence of child abuse and a bleeding disorder must always be considered. An extended coagulation diagnostic is required if the morphology of bleedings is not clearly suspicious for child abuse and in the absence of typical concomitant injuries, e.g., bone fractures. An interdisciplinary approach involving a forensic pathologist and a paediatric haemostaseologist for assessment of bleeding symptoms, the explanation of the clinical findings, and the critical evaluation of laboratory results are essential in such cases. This review is focussed on symptoms in accidental and nonaccidental injuries in children assisting haemostaseologists in decision making in cases of child protection issues.

scholarly journals Modern aspects of an investigation of the long tubular bones of the lower extremity in forensic medicine

2014 ◽  
Vol 18 (3 (71)) ◽  
Author(s):  
Ye. P. Fedorchuk-Neznakomtseva ◽  
L. L. Holubovych ◽  
O. I. Herasymenko
Keyword(s):  
Lower Extremity ◽  
Forensic Medicine ◽  
Medical Practice ◽  
Long Bones ◽  
Tubular Bones

The modern aspects and sequence of an investigation of the long tubular bones of the lower extremity have been disclosed. Their role in forensic-medical practice has been identified, while establishing and substantiating the mechanism of fractures of the long bones of the lower extremity.

scholarly journals Ewing’s sarcoma of fifth metacarpal with lung metastasis in a child: an unusual presentation

2017 ◽  
Vol 4 (5) ◽  
pp. 1903
Author(s):  
Nidhi N. Singh ◽  
V. Gupta ◽  
Ashutosh K. Singh
Keyword(s):  
Local Recurrence ◽  
Lung Metastasis ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Bone Tumour ◽  
Long Bones ◽  
Primary Surgery ◽  
Ewings Sarcoma ◽  
Poorly Differentiated ◽  
Small Bones

Ewing’s sarcoma is the second most common bone tumour second only to osteosarcoma which represents a family of malignancies of neuroendothelial origin, which are highly aggressive and poorly differentiated. The most frequent sites involved are shaft of long bones such as femur, tibia and flat bones such as pelvis and vertebra. Ewing’s sarcoma of small bones of hands is very rare and distant metastasis with hands as the primary is even rarer. Here we describe the course of a 11-year-old male who presented with ewings sarcoma of fifth metacarpal who presented with lung metastasis without local recurrence of the disease after primary surgery and later succumbed to his illness.

scholarly journals A Review on Medical Child Abuse and Child Protection

2021 ◽  
Vol 63 (3) ◽  
Author(s):  
Mustafa Hussein Ajlan Al-Jarshawi ◽  
Ahmed Al-Imam
Keyword(s):  
Child Abuse ◽  
Child Protection ◽  
Clinical Findings ◽  
Clinical Presentations ◽  
Medical Child Abuse ◽  
Three Stages ◽  
The Mean ◽  
One Year ◽  
The Uk ◽  
High Index Of Suspicion

Background Medical child abuse describes a child receiving unnecessary, harmful, or potentially harmful medical care at the caretaker's instigation. Objectives To focus on medical child abuse as an entity and emphasize its epidemiology, clinical presentations, prevention, and management. Results In the UK, the annual incidence of medical child abuse in children below one year increased to 3:100,000, while its prevalence in Arabs, including Iraq, is ambiguous due to lack of evidence and improper clinician's awareness. The mean age at diagnosis is 14 months to 2.7 years. Female caregivers are the most common offenders. Clinically, medical child abuse could fit into three stages; falsification of illness story, falsification of illness story and physical signs' fabrication, or induction of illness in children. A successful diagnosis mandates a comprehensive review of medical records to identify discrepancies between caregivers' stories versus clinical findings or investigations. Management requires recognizing abuse, halting it, securing the child's safety, maintaining the family's integrity when possible, and aborting unnecessary lateral referrals within the healthcare system. Conclusion Reported cases of medical child abuse are increasing steadily, while less severe ones go unrecognized. No diagnostic tool can help other than the physician's high index of suspicion. The management follows the same principles applied for other forms of child abuse, while good medical practice ensures its prevention.

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