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Identification of rib fractures on chest x-ray (CXR) in a young child raises concern for a nonaccidental cause of injury. In a subgroup analysis of a retrospective study of chest x-ray findings in children younger than 2 years, researchers compared the prevalence of rib fractures between patients who had known accidental trauma and those for whom there was concern for nonaccidental trauma (NAT).
Among 223 children with accidental trauma (mean age, 10.8 months), injury mechanisms included high-speed motor vehicle crash (MVC), fall from >20 feet, and crushing; injuries included skull and long bone fractures, intracranial hemorrhage, and death (4 children). Only one patient (0.45%) had CXR evidence of rib fracture. No patient had evidence of he…