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Rickets vs. abuse: a national and international epidemic
Kathy A. Keller, Patrick D. Barnes
- Bone changes can be subtle in early infancy.
- An inexperienced radiologist may miss Rickets on Xray.
- Differentiating between rib fractures and “Looser Zones” (pseudofractures seen in Rickets) on xray may be difficult.
- This would equate to a misdiagnosis of rib fractures in a child with Rickets.
- Timing of fractures in Rickets is impossible – it can only be assumed that healing will be delayed.
- Multiple Fractures in various stages of healing may all be from the same event and longer ago than originally thought if a diagnosis of Rickets is made.
- Bone Density Studies are unreliable in infants under 6 months of age.
- You can’t tell on xray if the bones are weak until after 6 months.
Keller, K. A., & Barnes, P. D. (2008). Rickets vs. abuse: a national and international epidemic. Pedatric Radiology.
Full text available online: http://www.stanford.edu/~pbarnes/docs/publications/Rickets_Abuse.pdf