Skeletal trauma: General considerations

Paul K. Kleinman, Andrew Rosenberg, Andy Tsai

Research output: Chapter in Book/Report/Conference proceedingChapter

5 Scopus citations


Introduction Fractures are common injuries in abused children, second only to cutaneous bruising (1). Although fundamental to the documentation of abuse, the fractures are rarely life-threatening and few result in long-term deformity. Specific types of fractures are known to be associated with abuse, and their recognition is important for their accurate identification and in understanding their significance. Many reports of unexplained subdural hematomas (SDHs) in infants had appeared before Caffey’s historic 1946 article, but it was only after he associated these lesions with certain patterns of skeletal injury that the modern medical entity of child abuse was formulated (2). In a sense, recognition of the role of skeletal injuries in child abuse became the catalyst for the surge of interest in child maltreatment after Caffey’s original description. In the years that followed, most reports of child abuse focused mainly on the radiologic alterations associated with the skeletal trauma (3-14). The confident documentation of skeletal injury, facilitated by characteristic radiologic alterations, provided investigators the opportunity to study the multiple facets of child abuse. Eventually, the blend of the clinical and the radiologic findings led Kempe, Silverman, and others to bring these associations to the status of the "battered child syndrome" (15).

Original languageEnglish (US)
Title of host publicationDiagnostic Imaging of Child Abuse
PublisherCambridge University Press
Number of pages30
ISBN (Print)9780511862366, 9781107010536
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Medicine(all)


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