Kosaraju Sriya,  Errampalli Eric,  Illimoottil Mathew,  Illimoottil Sarah,  Tran Noelle,  Leland Kristin,  Mardis Neil

Final Pr. ID: Poster #: EDU-061

The diagnosis of non accidental trauma (NAT) has significant clinical, therapeutic and social implications for the patient and the family. The recognition of suspicious fractures and fracture patterns, in conjunction with the clinical findings, plays an important role in the accurate diagnosis. However, there are congenital, metabolic and infectious processes that can mimic skeletal findings of NAT. Radiologists must be cognizant of these mimics and recognize the imaging and clinical findings that differentiate them from NAT to ensure accurate diagnosis and appropriate intervention.

This educational exhibit aims to elucidate the key radiographic features and clinical presentations that distinguish NAT from conditions that can mimic its appearance, such as osteogenesis imperfecta, rickets, and metabolic bone diseases.

Through a series of case studies and imaging examples, we will explore the skeletal findings of NAT mimics and compare them with the common fracture patterns associated with NAT, highlighting the imaging and clinical findings that differentiate the two. We will emphasize the importance of a thorough patient history and multidisciplinary approach in evaluating suspected cases of abuse.

By understanding the nuances of NAT mimics, radiologists can improve their diagnostic acumen, reduce the risk of misdiagnosis, and ultimately contribute to better patient outcomes. Read More

Authors:  Kosaraju Sriya , Errampalli Eric , Illimoottil Mathew , Illimoottil Sarah , Tran Noelle , Leland Kristin , Mardis Neil

Keywords:  Fractures, Skeletal Survey, NAT/Abuse

Verhulst Conner,  Boedefeld Isabella,  Fite Johnston

Final Pr. ID: Poster #: EDU-086

Menkes disease is a rare X-linked recessive disorder of copper metabolism characterized by mutations in the ATP7A gene. It is a rapidly progressive, multisystem disorder that usually results in death in early childhood. Along with a distinctive clinical presentation, Menkes disease demonstrates various musculoskeletal and neurologic imaging findings. Some of these findings, such as subdural hemorrhage, are also highly correlated with cases of non-accidental trauma in the pediatric population and could lead a case of Menkes disease to be suspected as physical abuse on first glance. It is essential for pediatric diagnostic radiologists to be vigilant for findings suggestive of physical abuse in all imaging that they review, but important to recognize when these findings may be present as a part of a larger clinical picture. In this educational poster we will review the characteristic clinical presentation of Menkes disease, examine MRI and X-ray findings of Menkes disease that overlap with findings of pediatric non-accidental trauma, and review more specific radiologic findings frequently seen with Menkes disease. Read More

Authors:  Verhulst Conner , Boedefeld Isabella , Fite Johnston

Keywords:  Menkes, NAT

Alucozai Doonyah,  Marine Megan,  Karmazyn Boaz,  Newman Christopher

Final Pr. ID: Poster #: EDU-060

Fractures are among the most common injuries detected radiologically in cases of suspected child abuse. However, normal developmental variants may resemble fractures on imaging and can pose a challenge for accurate diagnosis. The aim of this educational exhibit is to review normal anatomic variants that can mimic child abuse injuries and outline key imaging features that help distinguish these normal variants from traumatic injuries.

Examples from the skull include include accessory sutures and vascular channels, which can mimic linear calvarial fractures. Examples from the thorax include accessory ossification centers, bifid ribs, pseudarthroses, costochondral junction variants, and sternal ossification centers, which can mimic healing rib fractures. Examples from the long bones include metaphyseal collars, cortical stepoffs, metaphyseal spurs, and metaphyseal fragmentation, all of which can mimic classic metaphyseal lesions.

Anatomic variants are presented alongside the injuries that they often mimic in order to demonstrate the key imaging features that permit improved discrimination. Further imaging and clinical correlation are provided to demonstrate the benign nature of anatomic variations. A diagnostic checklist is provided for differentiating these variants from fractures in unknown cases.

Understanding normal developmental patterns and the radiological appearance of common variants in the pediatric skeleton is critical for the accurate interpretation of imaging studies in order to avoid overdiagnosing fractures that would otherwise cause high concern for child abuse. Read More

Authors:  Alucozai Doonyah , Marine Megan , Karmazyn Boaz , Newman Christopher

Keywords:  NAT/Abuse, Musculoskeletal, Anatomy

Gensel Anna,  Karmazyn Boaz,  Forbes-amrhein Monica

Final Pr. ID: Paper #: 115

This study aimed to elucidate the imaging appearance of costochondral junction (CCJ) fractures in young children, determine the association with nonaccidental trauma (NAT), and suggest a mechanism for injury. Read More

Authors:  Gensel Anna , Karmazyn Boaz , Forbes-amrhein Monica

Keywords:  Child Abuse, CCJ fracture, NAT