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Temporary brittle bone disease: fractures in medical care
1University of Dundee, Dundee, UK. c.s.paterson@btinternet.com
Insights
Temporary brittle bone disease causes infant fractures, often mistaken for abuse. This study presents five cases, supporting the disease's existence and differentiating it from non-accidental injury.
Area of Science:
- Pediatrics
- Radiology
- Forensic Medicine
Background:
- Temporary brittle bone disease (TBBD) is a controversial syndrome characterized by infant fractures within the first year of life.
- Radiological findings in TBBD can resemble those of non-accidental injury, leading to diagnostic challenges.
Observation:
- This study details five infants exhibiting classic TBBD features.
- A significant proportion of fractures in these cases occurred while the infants were hospitalized.
Findings:
- The observed fracture patterns in the hospitalized infants strongly suggest TBBD.
- Elimination of non-accidental injury as a cause was possible with a high degree of confidence.
Implications:
- These findings provide crucial evidence supporting the existence of temporary brittle bone disease.
- The study aids in distinguishing TBBD from non-accidental injury, improving diagnostic accuracy in pediatric cases.
Abstract:
Temporary brittle bone disease is the name given to a syndrome first reported in 1990, in which fractures occur in infants in the first year of life. The fractures include rib fractures and metaphyseal fractures which are mostly asymptomatic. The radiological features of this disorder mimic those often ascribed to typical non-accidental injury. The subject has been controversial, some authors suggesting that the disorder does not exist. This study reports five infants with typical features of temporary brittle bone disease in whom all or most of the fractures took place while in hospital. A non-accidental cause can be eliminated with some confidence, and these cases provide evidence in support of the existence of temporary brittle bone disease.
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