Metaphyseal and Rib Fractures in Child Abuse
Metaphyseal and Rib Fractures in Child Abuse
Metaphyseal and Rib Fractures in Child Abuse
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Jeremy Tucker, HMS IV<br />
Gillian Lieberman, MD<br />
Chronically, what happens?<br />
<strong>Metaphyseal</strong> vessels damaged<br />
= loss of signal that normally leads to morphologic<br />
death/differentiation of term<strong>in</strong>al chondrocyte.<br />
chondrocyte.<br />
PERSISTENCE rather than DEMISE of term<strong>in</strong>al<br />
chondrocyte = osseous growth arrest<br />
Epiphyseal vessels undamaged = chondrocyte proliferation<br />
cont<strong>in</strong>ues<br />
Abnormal survival of cells causes net <strong>in</strong>crease <strong>in</strong> cell<br />
number present with<strong>in</strong> cartilage column.<br />
= Metaphysis does not <strong>in</strong>vade physis column<br />
Rang, Mercer. The growth plate <strong>and</strong> its disorders. Baltimore, Williams <strong>and</strong> Wilk<strong>in</strong>s Company, 1969.<br />
Kle<strong>in</strong>man, PK. Diagnostic Imag<strong>in</strong>g of <strong>Child</strong> <strong>Abuse</strong>, Second Edition. 1998<br />
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