Common and Consequential Fractures That Should Not Be Missed in Children.

Document Type

Article

Publication Date

9-2022

Identifier

DOI: 10.3928/19382359-20220706-05

Abstract

Missed or delayed diagnosis of fractures in children is not uncommon owing to their immature skeletons, unique fracture patterns, and distinctive radiologic findings. The term occult is used to describe radiographically subtle fractures. Some of these fractures can be associated with excellent outcomes despite the pitfalls of delayed diagnosis. However, a subset of these injuries have more guarded prognoses when missed, despite their harmless radiographic appearance. A high index of suspicion should be maintained when treating pediatric extremity injuries with clinical findings disproportionate to a benign-appearing radiograph. Moreover, overreliance on radiology reports can perpetuate diagnostic error. In cases of discrepancy, timely follow-up for repeat examination or immediate advanced imaging can help avoid missed diagnoses. Most critically, the one diagnosis not to miss is nonaccidental trauma, as continued exposure to abuse puts the child at risk of further injury and death.

Journal Title

Pediatric annals

Volume

51

Issue

9

First Page

357

Last Page

363

MeSH Keywords

Child; Child Abuse; Diagnostic Errors; Fractures, Bone; Humans; Missed Diagnosis

Keywords

Child Abuse; Diagnostic Errors; Bone Fractures; Missed Diagnosis

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