We've updated our Privacy Policy to make it clearer how we use your personal data.
We use cookies to provide you with a better experience, read our Cookie Policy
EP30700
Poster Title: Accessory Parietal Suture versus Parietal bone fracture in a case of suspected Non-accidental injury- A real life Diagnostic dilemma
Submitted on 27 Sep 2019
Author(s): Dr ZY Nizar, Dr VK Baskaradoss
Affiliations: Bedford Hospital
This poster was presented at BIR Annual Congress 2019
Poster Views: 547
Submitted on 27 Sep 2019
Author(s): Dr ZY Nizar, Dr VK Baskaradoss
Affiliations: Bedford Hospital
This poster was presented at BIR Annual Congress 2019
Poster Views: 547
Abstract: Radiological differentiation between sutures and fractures is difficult in neonatal population due to the presence of multiple synchondroses and rare accessory sutures. Plain film evaluation has been replaced by Spiral and Multidetector CT over the last few decades due to the diagnostic confidence offered in such an enigma.
We herein report an unusual case of a 14-week old infant presenting with a suspicion of Non-accidental head injury and a Parietal bone defect but no clinical or radiological features suggestive of trauma.
We would like to highlight the factors pertinent to radiological distinction of both which is crucial especially in the current context of suspected Non-accidental head injury since delayed diagnosis worsens prognosis. Knowledge of the radiological appearance of accessory sutures and its differences from fractures is paramount in identification of children suspected with Non-accidental injury as the management of both are divergent and has many litigious implications. On the contrary it reduces the morbidity and mortality associated with false negative interpretation of fractures as sutures in the context of accidental or non-accidental head injurySummary: This poster is a case report of a 14 week old infant who was suspected to have a skull fracture following a high suspicion of Non-accidental head injury from violence or parent abuse which turned out to be an accessory skull suture. This clinical case had much medico-legal significance.References: 1.Kemp AM, Butler A, Morris S, Mann M, et al. Which radiological investigations should be performed to identify fractures in suspected child abuse? Clin Radiol. 2006;61(9):723–736. doi: 10.1016/j.crad.2006.03.017.
2. Kleinman PK, Spevak MR. Soft tissue swelling and acute skull fractures. J Pediatr. 1992;121(5):737–739. doi: 10.1016/ S0022-3476(05)81904-3
3. Nakahara K, Miyasaka Y, Takagi H, Kan S, Fujii K. Unusual accessory cranial sutures in pediatric head trauma—case report.
4. Weir P, Suttner NJ, Flynn P, McAuley D. Normal skull suture variant mimicking intentional injury. BMJ. 2006;332(7548):1020–1021 5. Meservy CJ, Towbin R, McLaurin RL, Myers PA, Ball W. Radiographic characteristics of skull fractures resulting from child abuse.
We herein report an unusual case of a 14-week old infant presenting with a suspicion of Non-accidental head injury and a Parietal bone defect but no clinical or radiological features suggestive of trauma.
We would like to highlight the factors pertinent to radiological distinction of both which is crucial especially in the current context of suspected Non-accidental head injury since delayed diagnosis worsens prognosis. Knowledge of the radiological appearance of accessory sutures and its differences from fractures is paramount in identification of children suspected with Non-accidental injury as the management of both are divergent and has many litigious implications. On the contrary it reduces the morbidity and mortality associated with false negative interpretation of fractures as sutures in the context of accidental or non-accidental head injurySummary: This poster is a case report of a 14 week old infant who was suspected to have a skull fracture following a high suspicion of Non-accidental head injury from violence or parent abuse which turned out to be an accessory skull suture. This clinical case had much medico-legal significance.References: 1.Kemp AM, Butler A, Morris S, Mann M, et al. Which radiological investigations should be performed to identify fractures in suspected child abuse? Clin Radiol. 2006;61(9):723–736. doi: 10.1016/j.crad.2006.03.017.
2. Kleinman PK, Spevak MR. Soft tissue swelling and acute skull fractures. J Pediatr. 1992;121(5):737–739. doi: 10.1016/ S0022-3476(05)81904-3
3. Nakahara K, Miyasaka Y, Takagi H, Kan S, Fujii K. Unusual accessory cranial sutures in pediatric head trauma—case report.
4. Weir P, Suttner NJ, Flynn P, McAuley D. Normal skull suture variant mimicking intentional injury. BMJ. 2006;332(7548):1020–1021 5. Meservy CJ, Towbin R, McLaurin RL, Myers PA, Ball W. Radiographic characteristics of skull fractures resulting from child abuse.
Ask the author a question about this poster.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Related Posters
Audit of Achilles tendon ultrasound: appropriateness and timeliness
Akash Sharma, Denis Remedios
A Pictoral review of active and long-standing Crohn's Disease
Afreen Ameer Hussain1, Arafat Muhammed Haris2
Is MRI Arthrogram a reliable investigation for Posterior Labrum tears of Shoulder?
R.Saini, S.Chinna, C Sharma, V.Jain, S.Kumar, R.Kothari, S Chau, C Fang
Peer Review Audit of Accuracy of Radiology Reports at Croydon University Hospital 2020
Dr Sophie Canham and Dr Ketul Patel
Radiation dose in paediatric CT during and after changes
Berglind Eik Ólafsdóttir, Jónína Guðjónsdóttir