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Case Report
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| Rib fractures: Accidental or non-accidental | ||||||
| Muhammad Waseem1, Evelyn Erickson2 | ||||||
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1Department of Emergency Medicine, Lincoln Medical & Mental Health Center, Bronx, NY, United States.
2PGY-1 Resident, Department of Pediatrics, Lincoln Medical and Mental Health Center, Bronx, NY, United States. | ||||||
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| How to cite this article: |
| Waseem M, Erickson E. Rib fractures: Accidental or non-accidental. International Journal of Case Reports and Images 2013;4(1):58–61. |
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Abstract
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Introduction:
We report an incidental discovery of multiple rib fractures in a wheezing child without a history of an injury or the presence of metabolic bone disease. As a result, the child was evaluated for the presence of non-accidental trauma.
Case Report: An 11-month-old African-American child was brought to the emergency department by his father with a 2-day history of fever, cough and breathing difficulty. After receiving nebulizer treatments, the child was still wheezing. A chest X-ray was obtained which showed bilateral fractures of the ribs. No history of trauma was provided. Given the radiographic findings, Child Protective Services was contacted and a report of child abuse was made. Conclusion: Child abuse is a complex phenomenon. Any skeletal injury in young children can be due to abuse. Rib fractures are uncommon in the pliable chest of a child. When discovered, however, they raise the suspicion of a non-accidental trauma. They are often uncovered during the assessment of children who present to the emergency department for unrelated reasons. The physician's ability to differentiate accidental from non-accidental trauma may depend on gathered information. This report emphasized the importance to evaluate for non-accidental trauma after the finding of bilateral rib fractures on a chest X-ray. Non-accidental trauma should be considered when there is evidence of injury without a history of trauma. | |
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Keywords:
Non-accidental trauma, Rib fractures, Child abuse
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Author Contributions
Muhammad Waseem – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published Evelyn Erickson – Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Muhammad Waseem et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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