![]() His complete blood count and basic metabolic profile were normal. ![]() Physical examination revealed no bruising, swelling, abnormal marks or other signs of trauma. The patient lived with his father and had not attended school or daycare. The medical history revealed prior episodes of wheezing in a developmentally appropriate child. The rest of the physical examination was normal. He had a temperature of 101.2☏, heart rate of 112/min, respiratory rate of 30/min, and an oxygen saturation of 95%. On arrival, he was noted to be wheezing and was directly brought to the asthma room. We report an incidental discovery of multiple rib fractures in a wheezing child.Īn 11-month-old African-American, asthmatic child was brought by his father to the emergency department during the winter with a two-day history of fever, cough and breathing difficulty. In the absence of a documented history of significant injury or the presence of metabolic bone disease, non-accidental trauma is the most likely presumed diagnosis. Most abused children present without a plausible explanation for their injuries. Non-accidental trauma is a common cause of morbidity and mortality in young children, but the diagnosis is not always apparent. Rib fractures are uncommon in infants and children. Non-accidental trauma, Rib fractures, Child abuse Non-accidental trauma should be considered when there is evidence of injury without a history of trauma. This report emphasized the importance to evaluate for non-accidental trauma after the finding of bilateral rib fractures on a chest X-ray. The physician's ability to differentiate accidental from non-accidental trauma may depend on gathered information. They are often uncovered during the assessment of children who present to the emergency department for unrelated reasons. When discovered, however, they raise the suspicion of a non-accidental trauma. Rib fractures are uncommon in the pliable chest of a child. Any skeletal injury in young children can be due to abuse. Given the radiographic findings, Child Protective Services was contacted and a report of child abuse was made.Ĭhild abuse is a complex phenomenon. A chest X-ray was obtained which showed bilateral fractures of the ribs. After receiving nebulizer treatments, the child was still wheezing. ![]() As a result, the child was evaluated for the presence of non-accidental trauma.Īn 11-month-old African-American child was brought to the emergency department by his father with a 2-day history of fever, cough and breathing difficulty. We report an incidental discovery of multiple rib fractures in a wheezing child without a history of an injury or the presence of metabolic bone disease. International Journal of Case Reports and Images 2013 4(1):58–61. Rib fractures: Accidental or non-accidental. Rib fractures: Accidental or non-accidentalġDepartment of Emergency Medicine, Lincoln Medical & Mental Health Center, Bronx, NY, United States.ĢPGY-1 Resident, Department of Pediatrics, Lincoln Medical and Mental Health Center, Bronx, NY, United States.Įmail: full text article on other devices
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