Skeletal survey in a 4-year-old child with suspected non-accidental injury (NAI) reveals corner fractures (metaphyseal chip fractures) of the distal femur and proximal tibia bilaterally. These fractures are MOST specific for:
- A Rickets
- B Osteogenesis imperfecta
- C Non-accidental injury (child abuse) ✓
- D Scurvy
Correct answer: C. Non-accidental injury (child abuse)
Explanation
Classical metaphyseal lesions (CML), also called 'corner fractures' or 'bucket-handle fractures,' are caused by shearing forces on the poorly mineralised metaphysis and are highly specific for non-accidental injury. Rickets causes widening and cupping of the metaphysis. Osteogenesis imperfecta causes osteopenia and diaphyseal fractures but not specifically CML. Scurvy causes periosteal haemorrhage and Trümmerfeld zone, not CML.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.