Day 1 - Case 3

K Groven Løitegård 1), E Klev 1,4), A Stray-Pedersen 2), AG Bechensteen 3), S Brügmann-Pieper 4), M Hellebostad 3), LS Ording Müller 1), C de Lange 1).
1) Div. of Radiology and Nuclear Medicine, Pediatric section, Oslo University Hospital, Oslo/NO
2) Dept. of Forensic medicine, Oslo University Hospital
3) Div. of Pediatric and Adolescent Medicine, Oslo University Hospital.
4) Dept. of Pediatrics, Vestre Viken Hospital Trust, Drammen

Clinical history:
A healthy 13 months old boy from the Gambia presented with acute pain in his right hand/foot following a fall injury seven weeks earlier. Radiographs detected a subacute tibial fracture and possible fracture sequelae in the 3rd metacarpal/1st metatarsal bone. Acute admission and skeletal survey were performed for suspected child abuse.

Possible answers
  • Accidental injury
  • Non-accidental injury
  • Sickle cell disease
  • Metabolic bone disease
  • Tuberculous dactylitis

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