Vitamin D deficiency rickets and allegations of non-accidental injury.
Vitamin D deficiency rickets has long been recognized as a cause of fractures and fracture-like appearances in young children. Often seen in the early 20th century, rickets has recently been regarded as uncommon; the radiological appearances, familiar to previous generations, may not be recognized for what they are. This article reports four children with unexplained fractures initially attributed confidently to non-accidental injury. In each case, the later evidence of vitamin D deficiency led to a reconsideration of that diagnosis.


CONCLUSIONS
It is important to be aware of this bone disorder in the differential diagnosis of fractures, to investigate appropriately and to recognize that the radiological appearances may be misleading. A mistaken diagnosis of abuse does real harm, not least to the child itself.
Paterson
Colin R
CR
University of Dundee, Dundee, UK. c.s.paterson@btinternet.com
D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D003951:Diagnostic Errors; D005260:Female; D005581:Foster Home Care; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012279:Rickets / Q000150:complications / Q000175:diagnosis*; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications*
D014807:Vitamin D