Temporary brittle bone disease versus suspected non-accidental skeletal injury

摘要: Temporary brittle bone disease has been proposed again as an alternative explanation for suspected non-accidental injury. This is still not considered a real entity by mainstream opinion. The recent publications remind us to look carefully explanations and investigate predisposing disorders thoroughly. When child presents with unexplained skeletal injury, the age, history of presentation level mobility important. absence clear explain injury raises issue (NASI). It also important consider any underlying disorder that might predispose fracturing normal handling force. NASI medicolegal implications children parents. In UK, experts must provide balanced impartial evidence assist court. Lawyers are instructed various parties but expert independent. Against this background judge balances contrary medical Many have be considered. Courts faced issues scientific hypothesis, leading edge research epidemiological data court best arena discussion. Paterson first concept temporary (TBBD) in 1993.1 He described personal series 39 who had fractures year life. TBBD transient predisposition fracture force, without bruising, proven diagnosis or biochemical abnormality. They suggested was due immaturity fragility collagen related trace element deficiency (eg, copper) osteogenesis imperfecta (OI). provided no specific test confirm TBBD. There complete table on their cases there lack comprehensive biochemistry results. presented theoretical attractively benign NASI …