SynthesisClinical orthopaedics and related research2011
Unexplained fractures: child abuse or bone disease? A systematic review.
Synthesis in Clinical orthopaedics and related research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Does osteogenesis imperfecta predispose infants to metaphyseal fractures? A systematic review.BMJ paediatrics open · 2026Pooled it
- Reviewing hereditary connective tissue disorders: Proposals of harmonic medicolegal assessments.International journal of legal medicine · 2024Pooled it
- Phenotypic spectrum of 1q21.1 copy number variants in 42 children: genotype-phenotype correlations and clinical implications.European journal of pediatrics · 2026Article
- Developing an artificial intelligence tool for detecting fractures of child abuse: preliminary findings.European radiology · 2026Article
- Osteogenesis Imperfecta or Non-accidental Trauma? The Diagnostic Dilemma in Pediatric Fractures.Journal of the Pediatric Orthopaedic Society of North America · 2025Article
- Early Life Stress (ELS) Effects on Fetal and Adult Bone Development.Children (Basel, Switzerland) · 2023Review
- Congenital syphilis as the cause of multiple bone fractures in a young infant case report.BMC pediatrics · 2022Article
- Imaging of pediatric bone and growth disorders: Of diagnostic workhorses and new horizons.Wiener medizinische Wochenschrift (1946) · 2021Article
- Reproductive options for families at risk of Osteogenesis Imperfecta: a review.Orphanet journal of rare diseases · 2020Review
- Mimic for Child Physical Abuse: Biochemical and Genetic Evidence of Hypophosphatasia without Classic Radiologic Findings.Case reports in pediatrics · 2020Article
- Finite element modelling of the developing infant femur using paired CT and MRI scans.PloS one · 2019Article
- Imaging of non-accidental injury; what is clinical best practice?Journal of medical radiation sciences · 2018Review
- Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect.Dermato-endocrinology · 2017Article
- Alagille syndrome case report: implications for forensic pathology and anthropology.International journal of legal medicine · 2015Article
- A brief history of fatal child maltreatment and neglect.Forensic science, medicine, and pathology · 2014Review
- Letter to the editor: Unexplained fractures: child abuse or bone disease: a systematic review.Clinical orthopaedics and related research · 2011Article
- Letter to the editor: Unexplained fractures: child abuse or bone disease: a systematic review.Clinical orthopaedics and related research · 2011Article
- Child abuse: review of the literature.Revista brasileira de ortopediaReview
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChild abuse and neglect (CAN) is a serious problem that has major implications for the welfare of the child involved. Unexplained fractures are of particular concern to the orthopaedic surgeon, who must often consider alternative diagnoses to CAN. QUESTIONS/PURPOSES: We therefore (1) determined which bone diseases most commonly mimic CAN; (2) what types of osteogenesis imperfecta (OI) are most commonly confused with CAN and why; and (3) what specific findings in OI and bone disease render a mistaken diagnosis of CAN more likely.
methodsA systematic review of the literature was performed. We identified studies that compared cases of CAN with cases in which patients had bone disease that resulted in an unexplained fracture. We also included studies in which patients with fractures resulting from underlying bony pathology were misclassified as CAN and were subsequently reclassified as bone disease as a result of further investigation. Our search netted only five studies that directly compared and contrasted CAN with metabolic or genetic bone disease in the same study.
resultsThe published literature suggests OI is most frequently confused with CAN, although metaphyseal dysplasia, disorders of phosphate metabolism, and temporary brittle bone disease are also documented in the literature identified by our search. Difficulty in differentiating these bony diseases from CAN stems from ambiguity in the history and physical examination at the time of presentation.
conclusionsBone disease is a diagnosis of exclusion in the differential diagnosis of CAN.
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