Coronal cleft vertebra initially suspected as an abusive fracture in an infant

Area of Science:

• Pediatric pathology
• Developmental biology
• Forensic medicine

Background:

• A four-month-old infant presented after being found unresponsive.
• Initial radiography suggested a traumatic vertebral fracture, raising concerns of non-accidental trauma.
• The infant survived for four days post-admission.

Observation:

• Autopsy examination contradicted the radiographic findings of a vertebral fracture.
• A developmental anomaly, possibly related to notochord regression failure, was identified in the vertebral bodies.
• No other significant pathological findings were noted during the autopsy.

Findings:

• The presumed vertebral fracture was determined to be a developmental defect.
• Sudden Infant Death Syndrome (SIDS) was established as the final cause of death.
• The developmental anomaly had no apparent sequelae.

Implications:

• Highlights the importance of correlating imaging findings with autopsy in pediatric cases.
• Underscores the need for careful differential diagnosis in suspected abusive head trauma cases.
• Emphasizes that developmental anomalies can mimic traumatic injuries in infants.