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Journal Article

Citation

Bixby SD, Wilson CR, Barber I, Kleinman PK. Pediatr. Radiol. 2014; 44(9): 1175-1178.

Affiliation

Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA, sarah.bixby@childrens.harvard.edu.

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00247-014-2960-x

PMID

24687621

Abstract

We report a previously healthy 4-month-old who presented to the hospital with leg pain and swelling and no history of trauma. Radiographs demonstrated a comminuted left femur fracture. Given the concern for child abuse, skeletal survey was performed and revealed four vertebral compression deformities. Although abuse was suspected, the possibility of a lytic lesion associated with the femur fracture and multiple spinal abnormalities raised the possibility of an underlying process such as Langerhans cell histiocytosis. Subsequently 18F-NaF positron emission tomographic (PET) scintigraphy revealed increased tracer activity in the ischium, and MRI confirmed an ischial apophyseal fracture. Pelvic fractures, particularly ischial fractures, are extremely rare in the setting of child abuse. This case report describes the multimodality imaging findings of an ischial fracture in an abused infant.


Language: en

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