Dear Friends,We’re pleased to introduce Materia Medica, a monthly email complementing our quarterly newsletter. Materia Medica is a brief review of current literature in medicine relevant to criminal law designed to help prepare you for your next case.
As a valued subscriber to our quarterly newsletters, you are already signed up to receive Materia Medica. Do you know someone else who would benefit from this valuable information? Click here to share this email.
Rickets vs. abuse: a national and international epidemic
Kathy A. Keller, Patrick D. Barnes
This commentary article regarding Rickets and child abuse appears in Pediatric Radiology. In summary, key facts that would support the defense in a child abuse case are:
- 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
