NCJ Number
51313
Journal
JOURNAL OF THE COLLEGE OF RADIOLOGISTS OF AUSTRALIA Volume: 9 Issue: 3 Dated: (OCTOBER 1965) Pages: 220-223
Date Published
1965
Length
4 pages
Annotation
RADIOGRAPHIC FEATURES OF 26 CHILDREN SUFFERING FROM THE BATTERED CHILD SYNDROME REVEALED BONE DAMAGE WHICH OFTEN CONSTITUTED THE SOLE EVIDENCE FOR THE SYNDROME.
Abstract
THE CLINICAL FEATURES OF THE 26 CHILDREN AT THE ADELAIDE CHILDREN'S HOSPITAL IN AUSTRALIA WERE OF MAJOR IMPORTANCE BOTH FOR DIAGNOSIS AND AS A GUIDE TO MANAGEMENT. THESE FEATURES INCLUDED GROSS FRACTURES, SUBPERIOSTEAL OSSIFICATION, METAPHYSEAL FRACTURES, AND EPIPHYSEAL DISPLACEMENTS. FRACTURES USUALLY OCCURRED IN CHARACTERISTIC SITES AND WERE OFTEN POLYOSTOTIC, ASYMMETRICAL, AND AT VARIOUS STAGES OF HEALING. THESE FINDINGS SUGGESTED THAT TRAUMATIC EPISODES HAD OCCURRED ON MORE THAN ONE OCCASION. THERE WERE MARKED DISCREPANCIES BETWEEN RADIOGRAPHIC FINDINGS AND HISTORICAL DATA SUPPLIED BY CARETAKERS. LESIONS HEALED RAPIDLY AND NO NEW LESIONS DEVELOPED WHEN THE CHILD WAS KEPT IN A HOSPITAL OR A PROTECTED ENVIRONMENT. THE MAJORITY OF BATTERED CHILDREN ARE INFANTS, USUALLY UNDER THE AGE OF 6 MONTHS WHEN FIRST INJURED. THE AMOUNT OF RADIOLUCENT CARTILAGE IS RELATIVELY GREAT AT THIS AGE, AND ANATOMICAL DISRUPTIONS CAN OCCUR WITHOUT BEING RADIOLOGICALLY VISIBLE. RADIOGRAPHS TAKEN 1 OR 2 WEEKS AFTER AN INJURY MAY, HOWEVER, REVEAL A TYPICAL REACTION THAT IS NOT USUALLY SEEN IN OLDER CHILDREN OR ADULTS. THIS OCCURS BECAUSE OF THE LOOSER ATTACHMENT OF THE INFANT PERIOSTEUM TO THE UNDERLYING CORTICAL BONE, ITS RICH BLOOD VASCULATURE, AND ITS VERY ACTIVE OSTEOGENETIC LAYER. THE IMPORTANCE OF RADIOLOGIC FINDINGS IS STRESSED SO THAT APPROPRIATE ACTIONS CAN BE TAKEN TO PREVENT THE RECURRENCE OF INJURY. DETAILED INFORMATION AND RADIOGRAPHS FOR THE DIFFERENT TYPES OF INJURY AMONG THE 26 CHILDREN ARE PROVIDED. REFERENCES ARE INCLUDED. (DEP)