Hosting 718 files, 2916 images, and 4 contributors.

 
Random Case

Neurofibromatosis, Multiple Cranial Manifestations
Joseph Junewick, MD FACR
over 7 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Case History


3 month old with possible inflicted trauma.


Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: CR
Activities:
Adobe32 PDF Imagej32 ImageJA

Case Images


Academic Case Revealer (Click to Expand)

Reveal Findings

CR – Triangular metaphyseal fragment anterior to the distal tibia with bucket handle component (arrows).

Reveal Discussion

Caffey initially described the bucket handle fracture, a metaphyseal fracture that is virtually pathognomonic of inflicted injury. These injuries are present nearly half of abused children less than 18 months of age and thought to be related to shear forces at the metaphysis-physis junction from violent shaking of the child. Most bucket handle fractures occur in the distal femur, proximal tibia, distal tibia, and proximal humerus. The periphery of the fracture extends obliquely toward the diaphysis creating a triangular fragment (corner fracture) whereas the central portion of the fracture extends toward the physis resulting in a thin fragment (bucket handle). The bony trabeculae in the primary spongiosa and the columns of calcified cartilage extending into the metaphysis are disrupted but the periosteum is usually intact. With healing there is little or no callus formation since the periosteum is relatively uninjured. Fortunately, the long-term sequelae of these injuries appear to be minimal.

Reveal Diagnosis

Metaphyseal Corner – Bucket Handle Fracture

Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare