PEDIATRIC Section 13: MSK (Non-Accidental Trauma [NAT])

Question 1

In a child under the age of 3, this is pretty reliable. Supposedly this type o f fracture can only be made from squeezing a child.

Answer 1

Posterior Medial Rib Fracture

Question 2

When this is present in a non-ambulatory patient (infant) it is HIGHLY specific. The only exception is obstetric trauma. After age 1, this becomes less specific.

Answer 2

Metaphyseal Corner Fractures

Question 3

Solid Organ and Lumeny injury that should get you to say NAT?

Answer 3

Duodenal Hematoma
Pancreatitis (From Trauma)

Question 4

Dating the Fracture

Periosteal Reaction:
Complete Healing:
Esceptions:

Answer 4

Periosteal Reaction: Fracutre < 1 week
Complete Healing: Around 12 weeks
Esceptions: Metaphyseal, skull, Costochondral junction

Question 5

What are the child abuse mimics?

Answer 5