Battered Child Syndrome; a Case Study.

One of the important and usual missed causes of pediatric traumas is child abuse. This ominous phenomenon, which can be presented physically, psychologically, sexually, and emotionally has grown significantly in recent years. Many children are not diagnosed in the early stages of evaluation. Battered Child Syndrome is used to describe the clinical condition of the child serious physical abuse by parents or caregivers. Medical staff should always keep the syndrome in their mind for those brought to the emergency department with trauma. In this report, we described a patient complained of dysphagia following a falling from a height and multiple epidural hematomas and final diagnosis of battered child syndrome.

Does preservation of active range of motion after acute elbow injury rule out the need for radiography?

BACKGROUND: We aimed to evaluate the role of a normal elbow active range of motion (ROM) in predicting low fracture risk and avoiding elbow X-ray in patients with acute elbow injuries. Lack of any approved rules for this purpose led us to evaluate simple physical examination methods to predict elbow fractures. METHODS: In this observational study, all patients with elbow injury who presented to two emergency departments were enrolled according to specific criteria. Patients were examined by emergency or orthopedics residents. Elbow radiographs were reviewed by a radiologist for fractures and soft tissue injuries. Results of the clinical examination and radiographs were recorded for statistical analysis. Sensitivity, specificity and positive and negative predictive values were calculated. RESULTS: Elbow fractures were identified in 10 of the 102 enrolled patients (9.8%). Nine of the 10 had limited ROM in all movements. Limited active elbow ROM in predicting elbow fracture revealed a sensitivity of 90%, specificity of 92%, and positive and negative predictive values of 56% and 98%, respectively. Individuals with limitation in one or two directions had no signs of fracture in the X-rays. CONCLUSION: Patients with elbow injury and a limited ROM in all directions of flexion, extension, supination and pronation require further X-ray investigations.