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

Meeting name: IPR 2026 Congress , 2026

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

Keywords: NAT/Abuse, Musculoskeletal, Anatomy