Of all children reported to child protective services for suspected maltreatment in any form, the percentage of substantiated cases of actual physical abuse is quite small. There are a number of dermatological or radiologically demonstrable musculoskeletal lesions that have been, or could be mistaken for, intentional physical abuse by the inexperienced or untrained observer.

Child Abuse and Its Mimics in Skin and Bone illustrates the classic manifestations of physical abuse by dermatological and radiological examination as a standard against which the mimickers of physical abuse can be compared. Beginning with a historical perspective on child abuse, the book explores manifestations of superficial and musculoskeletal trauma in children. It examines conditions often mistaken for child abuse, ranging from rubella to leukemia and bowing deformities to vitamin A intoxication, as well as a plethora of dermatological conditions that can mimic signs of physical abuse.

Designed for a broad spectrum of individuals who may first encounter a possibly abused child, the book presents hundreds of photos many in color and examples collected by the authors over their years of experience in their respective fields. Where appropriate, the authors provide pertinent historical, physical, and laboratory information in support of the diagnosis.

With the combined insight of top experts in forensic radiology and dermatology, this volume enables clinicians and others confronted with cases involving these conditions to avoid a rush to judgment that could wreak havoc in a family and quite possibly delay needed treatment for an actual medical condition

Trauma Inflicted or Accidental?

Incidence of Inflicted Trauma

Risk Factors

Suspicion, Substantiation, or Exclusion of Inflicted Trauma

Dermatologic Survey

Radiologic Survey

Musculoskeletal Trauma in Infants and Children: Accidental or Inflicted?

Part 1: Introduction

Injuries to the Bones and Joints in Children: Incidence

The Dilemma of Discrimination

Context Is Critical

Part 2: Radiological Findings in Nonaccidental Trauma

Introduction

Fractures of the Appendicular Skeleton

Fractures of the Axial Skeleton

The Skull

Radiological Mimickers of Physical Child Abuse

Metaphyseal Lesions

Scurvy

Rickets

Menkes Disease (Kinky-Hair Syndrome)

Congenital Syphilis

Intrauterine Infection

Rubella (German Measles)

Fetal Cytomegalovirus Infection

Metaphyseal Chondrodysplasias

Schmid Type

Leukemia

Meningococcemia

Little Leaguer's Shoulder

Hypophosphatasia

Stippled Epiphyses

Fractures and Bowing

Perinatal fractures/birth injuries

Handling or "nursing" fractures

Osteogenesis Imperfecta (OI)

Temporary Brittle Bone Disease (TBBD)

Bowing Deformities

Neurofibromatosis

Other Causes of Bowing Deformity

Congenital Indifference to Pain (Hereditary Sensory and Autonomic Neuropathy)

False Fractures

Factitious Splitting of the Femoral Head

Supernumerary Ossification Centers

Panner's Disease

Normal Fractures

The "Toddler's Fracture"

Supracondylar Fracture of the Humerus

Little Leaguer's Elbow

Dislocations Nontraumatic, Noninfectious, Nonabusive

Arthrogryposis

Larsen's Syndrome

Periosteal New Bone Formation

Scurvy

Rickets

Congenital Syphilis

Leukemia

Osteomyelitis

Infantile Cortical Hyperostosis (Caffey Disease)

Prostaglandin Therapy

Vitamin A Intoxication

Familial Hypophosphatemia

Normal Physiological Periostitis of the Newborn

The Spine

Coronal Cleft Vertebra

Vertical or Sagittal Cleft

Hemivertebrae

Spina Bifida

Physiological Sclerosis of the Newborn

Hurler Syndrome

Stippled Epiphyses

Infarction

Vertebra Plana

The Skull

Increased Pressure?

Fractures

Wormian Bones

Cephalohematoma

Leptomeningeal Cyst

Abnormal Fetal Packing

Ping-Pong Ball Fractures

Dermatological Signs of Physical Abuse

Bruises

Abrasions and Lacerations

Bite Marks

Hair Pulling

Burns

Burns by Hot Liquids

Contact burns

Neither/Nor Lesions

Cultural Remedies, Folk Medicine

Coining

Cupping

Moxibustion

Caida de la Mollera

Dermatological Mimics of Physical Abuse

Mimics of Bruises

Hyperpigmentation

Purpura

Lichen Aureus

Erythema Nodosum

Morphea

Fixed Drug Eruption

Pityriasis Rosea

Pyoderma Gangrenosum

Lichen Sclerosis et Atrophicus

Mimics of Other Pattern Injuries

Amniotic Bands

Striae

Staphylococcal Scalded Skin Syndrome (SSSS) Multiforme

Koebner Phenomenon

Burns

Lupus Erythematosis

Schamberg's Purpura

Pityriasis Lichenoides

Linear IgA Dermatitis

Bullous Mastocytosis

Pityriasis Rubra

Morphea

Pityriasis Rubra Pilaris

Ringworm/Tinea

Seborrheic Dermatitis

Staphylococcal Scalded Skin Syndrome

Epidermolysis Bullosa (Blistering Diaper Dermatitis)

Junctional Epidermolysis Bullosa

Toxic Epidermal Necrolysis (Steven Johnson Syndrome