Battered baby syndrome & Osteogenesis imperfecta

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Battered baby syndrome

Battered baby syndrome (BBS) refers to non-accidental injuries sustained by a child as a result of physical abuse, usually inflicted by an adult caregiver.

Classical radiological findings in a battered baby:

  1. Bucket handle fracture
  2. Corner’s fracture: Metaphyseal fracture at distal end of radius/ ulna
  3. Egg shell fracture of skull
  4. String of beads appearance due to fracture of multiple ribs.

How to differentiate fracture in a battered baby from Osteogenesis imperfecta?

  • Battered baby: Fracture is metaphyseal in location
  • Osteogenesis imperfecta:¬†Fractures are diaphyseal in location.


Osteogenesis imperfecta (OI)

  • Mutation in COL1A1 gene
  • Defective synthesis of type 1 collagen (present in bone)
  • Most common type: Type 1
  • Inheritance of type 1 OI: AD
  • Most severe type: Type 2
  • Inheritance of type 2 OI: AR
  • Radiology: Multiple diaphyseal fractures at different stages of healing
  • Van der hoeve syndrome consists of:
    1. Osteogenesis imperfecta
    2. Blue sclera
    3. Otosclerosis (As tympanogram)
  • So, in OI, As tympanogram might be seen
  • DOC: Bisphosphonates
  • Fracture: Telescopic intramedullary nailing.

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