Category: Visual Diagnosis
Posted: 11/25/2012 by Haney Mallemat, MD
(Updated: 11/26/2012)
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2 year-old male with past medical history of asthma presents with fever and respiratory distress. CXR is shown below. What’s the diagnosis? (Hint: ...look beyond the obvious)
Answer #1: Multifocal opacities predominantly in left lower lobe representing pneumonia
Answer #2 Healing left-sided rib fractures involving the lateral aspects of ribs 8 through 10th suspicious for non-accidental trauma (see X-ray below)
Pediatric CXR pearls
Bottom line: Screen patients for the above risk factors when rib fractures have been identified, but always think of abuse and the child’s safety first….and don’t forget to thoroughly examine radiology despite finding one abnormal finding.
Reference: Cosway et al. Diagnostic indicators for NAI in children with rib fractures: A retrospective study. Arch Dis Child 2011; 96 (supplement)
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