Battered baby syndrome & Osteogenesis imperfecta

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.