A regional approach to the classic metaphyseal lesion in abused infants: the distal femur

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

Abstract

The purpose of this study was to analyze the spectrum of morphologic alterations of the classic metaphyseal lesion involving the distal femur of abused infants and to identify features that aid in radiologic diagnosis and assessment of healing. Thirty-one infants who died with evidence of inflicted skeletal injury were studied with high-detail skeletal surveys, resected specimen radiography, and histologic analysis. We recorded the number of fractures, the portions of the distal femoral metaphyses involved, and the age of the lesions. Fifteen classic metaphyseal lesions of the distal femur were seen in 11 infants. The lesions were bilateral in four infants and unilateral in seven. Nine healing and three acute classic metaphyseal lesions were found. In the remaining three lesions, the age of the lesions was indeterminate. Fractures always involved the posteromedial aspect of the femur; anterior and lateral extension occurred in more diffuse lesions. Fractures tended to be less conspicuous when they were acute and were more easily recognized with healing, especially with specimen radiography. Histologically, the fracture line consistently undercut the medial subperiosteal bone collar. Extension of hypertrophic chondrocytes from t...Continue Reading

Citations

Mar 23, 2007·Pediatric Radiology·Annamarie O'Connell, Veronica B Donoghue
Jul 24, 2008·Pediatric Radiology·Paul K Kleinman
Sep 24, 2008·Pediatric Radiology·Carole Jenny
May 3, 2005·Journal of Clinical Forensic Medicine·Mahmut Asirdizer, Yildiray Zeyfeoglu
Oct 4, 2008·BMJ : British Medical Journal·Alison M KempSabine Maguire
Apr 22, 2009·AJR. American Journal of Roentgenology·Paul K KleinmanThaddeus W Herliczek
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
Jan 28, 2014·Forensic Science, Medicine, and Pathology·Ann H Ross, Chelsey A Juarez
Feb 18, 2015·Radiology·Jeannette M Perez-RosselloPaul K Kleinman
Apr 24, 2015·AJR. American Journal of Roentgenology·Angela ThompsonMary Clyde Pierce
Jul 7, 2014·Pediatric Radiology·Ignasi BarberPaul K Kleinman
Mar 17, 2004·Current Opinion in Pediatrics·Rebecca Tenney-Soeiro, Celeste Wilson
Dec 16, 2017·JBJS Case Connector·Kirsten Norrell, William Hennrikus
Oct 28, 2018·Pediatric Radiology·Boaz KarmazynRoberta A Hibbard
Nov 1, 2002·Journal of Pediatric Orthopedics·Paul A BanaszkiewiczElizabeth J Myerscough
Apr 20, 2004·Pediatric Emergency Care·Joshua C W JonesJames D Bruckner
Jun 28, 2008·Journal of Women & Aging·Robin D Moremen
Jan 24, 2020·Pediatric Radiology·Boaz KarmazynRoberta A Hibbard
Jul 4, 2007·Journal of Perinatal Medicine·David M CarrollBabyn S Paul

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