Metaphyseal and Rib Fractures in Child Abuse

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Jeremy Tucker, HMS IV Gillian Lieberman, MD Chronically, what happens? Metaphyseal vessels damaged = loss of signal that normally leads to morphologic death/differentiation of terminal chondrocyte. chondrocyte. PERSISTENCE rather than DEMISE of terminal chondrocyte = osseous growth arrest Epiphyseal vessels undamaged = chondrocyte proliferation continues Abnormal survival of cells causes net increase in cell number present within cartilage column. = Metaphysis does not invade physis column Rang, Mercer. The growth plate and its disorders. Baltimore, Williams and Wilkins Company, 1969. Kleinman, PK. Diagnostic Imaging of Child Abuse, Second Edition. 1998 34
Jeremy Tucker, HMS IV Gillian Lieberman, MD Healing of Focal Metaphyseal Injury 1. Terminal chondrocytes persist ONLY in focally damaged columns where transformation into bone is blocked. 2. Damaged columns blocked from calcification 3. Uncalcified region extends into calcified region Kleinman, PK. Diagnostic Imaging of Child Abuse, Second Edition. 1998. 35
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Metaphyseal and Rib Fractures in Child Abuse

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