Occult Rib Fractures: Defining the Cause

摘要: The probability of physical abuse (PA) is high in children with occult rib fractures. Other causes include non-intentional trauma, post surgery and cardiopulmonary resuscitation. Bone fragility increases the risk fractures, namely metabolic bone disease prematurity (MBDP), osteogenesis imperfecta, rickets rare diseases. ‘Occult fractures have a abuse’ This case series describes 61 under two years age associations clinical radiological features aetiology. There were 20 cases PA, 11 surgical three trauma. Two had following resuscitation, 18 MBDP one disease. In six cases, cause remained unknown. number distribution infants did not discriminate between PA. Fractures predominantly posterior, postero-lateral or lateral. All gestational 31 weeks less birth weight < 1.25 kg. Each child at least additional factor. Chronic lung was recorded seven, prolonged total parenteral nutrition ten, steroid use four, furosemide medication eight necrotising enterocolitis three. PA other associated injuries signs neglect. We recommend comprehensive assessment including an examination to exclude protection full factors for co-existing fragility.