All of the following are suggestive of domestic violence in a child except:
(A) Wormian bones (B) Microfractures in the sub-ep physeal region (C) Corner fractures (D) Bucket handle fractures of metaphyses
(A) Ans: A. Wormian bones(Ref: Reddy 34/e p417; Parikh 6/e p4. 187).Wormian bones are seen in Osteogenesis imperfecta and not child abuse.Wormian bones, also known as intrasutural bones or sutural bones, are extra bone pieces that can occur within a suture (joint) in the skull. These are irregular isolated bones that can appear in addition to the usual centres of ossification of the skull and, although unusual, are not rare'Battered baby' syndrome:Suspected due to severe & varied changes in metaphyses, periosteal new bone formation or epiphyseal separation.Also referred as "Caffey's Syndrome/Infantile Whiplash Syndrome".Injuries Type & Pattern:Arms & legs:Move about in a whiplash movement resulting in typical 'corner'or 'bucket-handle'-fractures in metaphyseal region.Classical metaphyseal corner or bucket handle fracture" - Viually pathognomonic for abuse.Fractures of acromion, sternum & spinous processes - High specificity for abuse.