Teaching Points
- Situations that evoke suspicion of non-accidental injury in children include -
- Fractures which raise suspicion for non-accidental injury eg rib fractures in young children and metaphyseal, corner or bucket handle fractures.
- Skull fractures without a history of trauma
- Fractures of varying ages
- Injuries which are not consistent with the history proffered
- If NAI is suspected it is important to seek specialist advice from a child protection unit at a major tertiary paediatric centre
- Investigations that may be utilised include plain radiographs, skeletal survey, computed tomography and bone scan
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