A regional approach to classic metaphyseal lesions in abused infants: the distal tibia

AJR. American Journal of Roentgenology
P K Kleinman, S C Marks

Abstract

The purpose of this study was to analyze systematically the spectrum of morphologic alterations of classic metaphyseal lesions (CML) involving the distal tibia of abused infants and to identify features that assist in the radiologic diagnosis and assessment of healing. Thirty-one infants who died with evidence of inflicted injury were studied with high-detailed skeletal surveys, resected-specimen radiography, and histopathologic analysis. The number of fractures identified, the portions of the distal tibial metaphyses involved, and the age of the lesion were assessed. A total of 16 CML of the distal tibia were noted. Eight infants had unilateral injury that always involved the left side, and four had bilateral lesions. When a CML was visible radiographically, it was always seen along the medial aspect of the metaphysis; lateral metaphyseal involvement was evident with more extensive injuries and always accompanied medial involvement. Fractures tended to be less conspicuous when acute and were more easily recognized with healing, especially with specimen radiography. Radiographically, the typical fracture separated a medial fragment that was tall and triangular; this appearance was histologically related to the undercutting of t...Continue Reading

Citations

Sep 24, 2008·Pediatric Radiology·Russell W Chesney
Sep 24, 2008·Pediatric Radiology·Carole Jenny
Oct 4, 2008·BMJ : British Medical Journal·Alison M KempSabine Maguire
Mar 24, 2010·Radiology·Laura A DrubachPaul K Kleinman
Jul 11, 2003·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Gael J LonerganSteven C Boos
Dec 29, 2013·AJR. American Journal of Roentgenology·David M AyoubMarvin Miller
Dec 29, 2013·AJR. American Journal of Roentgenology·Beverly P Wood
Mar 25, 2006·Journal of Pediatric Orthopedics·Marcin E DomzalskiJames T Guille
Sep 24, 1999·Radiologic Clinics of North America·S D John
Feb 18, 2015·Radiology·Jeannette M Perez-RosselloPaul K Kleinman
Mar 17, 2004·Current Opinion in Pediatrics·Rebecca Tenney-Soeiro, Celeste Wilson
Oct 28, 2018·Pediatric Radiology·Boaz KarmazynRoberta A Hibbard
Jul 20, 2017·Pediatric Radiology·Andy TsaiPaul K Kleinman
Aug 6, 2019·Pediatric Radiology·Gloria S LeeLori D Frasier
Jan 24, 2020·Pediatric Radiology·Boaz KarmazynRoberta A Hibbard
Mar 16, 2018·Pediatric Radiology·Andy TsaiPaul K Kleinman

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