Children with traumatic fractures commonly present to our institution whilst those with true pathological fractures occurring during normal activity or with minimal trauma are only rarely encountered.
As the treatment and prognosis may be quite different,
it is important that we are able to distinguish between traumatic and non-traumatic injuries and are alert to factors in the history,
examination and x-ray findings that may suggest the fracture is pathological.
This pictorial review will illustrate the pathological fractures we have encountered in children including true stress...
York Hospital catchment population is about 400 000 with approx.
60 000 <16 years,
most of our radiologists have minimal experience of paediatric patients.
Over the past 9 months we have had 4 children present with pathological fractures and this prompted us to review prior cases to look at the spectrum of pathologies that we have seen and the diagnostic problems we encountered.
Imaging findings OR Procedure Details
Bone Tumours and Tumour like Conditions
The vast majority of the pathological fractures we encounter in our department involve benign bone lesions.
MRI and occasional CT scans are obtained in our institution.
As a DGH,
unless there is an obvious simple cyst or a known predisposing condition,
advice is usually sort from the Paediatric bone tumour unit in Birmingham,
as to diagnosis and management of these lesions.
Unicameral bone cyst (UBC):
A unicameral bone cyst (UBC) represents about 3% of all primary benign bone...
Children only rarely present to a District General Hospital with pathological or insufficiency fractures and it is important that radiologists can confidently distinguish these from traumatic fractures,
so patients are triaged,
investigated and appropriately referred to a tertiary centre in a timely fashion
1-Unicameral bone cysts.Wilkins RMJ Am Acad Orthop Surg.
2000 Jul-Aug; 8(4):217-24.
2-Early management of pathological fractures inchildren.
2007 Feb; 38(2):194-200.
3-Pathologic fractures in children.Ortiz EJ,
Canosa RClin Orthop Relat Res.
2005 Mar; (432):116-26.
4- Fibrous dysplasia.
and treatment.DiCaprio MR,
Enneking WF.J Bone Joint Surg Am.
2005 Aug; 87(8):1848-64.
5-Metaphyseal fibrous defects.Betsy M,
Springfield DS.J Am Acad Orthop Surg.
2004 Mar-Apr; 12(2):89-95.
6-Pathological fractures through non-ossifying fibromas.