Look Out for Occult Fractures in Abused or Injured Children

In young children who suffer physical abuse, skeletal surveys have been shown to identify fractures that are not clinically suspected in 10% to 40% of children aged <2 years. Based on such findings, the American Academy of Pediatrics recommends that a skeletal survey be performed on all children aged <2 years who are suspected of having been physically abused. Despite these recommendations, the use of occult fracture examination in this high-risk group varies widely — from 55% to 93% — across U.S. hospitals. Moreover, this variability is even greater among infants aged <1 year who present with femur fractures or traumatic brain injuries that are not a result of a motor vehicle crash.

To further examine the rate of occult-fracture screening o…