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Accidental or innocent toddler fracture

Case contributed by Shailaja Muniraj
Diagnosis certain

Presentation

Jumped from bed. Refusal to walk.

Patient Data

Age: 1.2 years
Gender: Male

There is a faint radiolucent oblique line noted at the distal tibia, suggestive of undisplaced fracture. 

Adjacent subtle soft tissue thickening noted.

Case Discussion

This is a case of typical accidental or innocent toddler fracture.

Toddler fracture was first described by J S Dunbar in 1964.

In cases of non accidental toddler fracture, the suspicion for child abuse should be raised and evaluated accordingly. 

However the radiologist must be aware that osteogenesis imperfecta presenting as multiple metaphyseal fractures can be confused for child abuse. Similar such confusion can arise in patients with disuse demineralization due to cerebral palsy and neuromuscular disease.

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