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Old 04-19-2010
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Bones Mutliple Metaphyseal Fractures

A 6-month-old boy is found to have bilateral metaphyseal fractures of both proximal and distal ends of the tibia. The mother says that her boyfriend takes care of the infant while she is at work. Her boyfriend explains the injuries as the result of multiple falls from bed. Which of the following is the most likely diagnosis?

A. Accidental trauma
B. Osteogenesis imperfecta
C. Osteopetrosis
D. Physcial abuse
E. Rickets
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aungawa (04-19-2010), ayesha chaudhry (04-20-2010)

Old 04-19-2010
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Default is it A?!

I think its accidental trauma....
i wouldn't expect it to be osteogensis imperfecta... cause it should already be diagnosed
and i ruled out abuse cause at the age of 6 months a child starts to roll over and crawl and creep... so he might have fallen out of bed... every detail in a USMLE question is there for a meaning... isn't it
but it might be abuse since he left the child to fall out multiple times...
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Old 04-19-2010
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Default Child abuse for sure

This is definitely child abuse there's no single doubt about that.

The family setting is the commonest risk factor and the infant is having bilateral proximal and distal fractures, this boyfriend almost killed the baby
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