Costochondral Junction Variations Can Mimic Fractures in Children

Background: Rib fractures are among the most common fractures detected in victims of child abuse, and posterior rib fractures in infants are highly specific injuries seen in abuse. Costochondral rib fractures, although uncommon, are another injury specific to child abuse and are usually occult on radiography, most often detected in the healing phase during skeletal survey CT. The healing process of this type of rib fracture differs from conventional rib fractures, with growth disturbance of the costochondral junction most noted (instead of subperiosteal bone formation and callus as seen in conventional rib fractures). The concern is that variations in the costochondral junction in children aged Objective: To evaluate the types, location, and incidence of costochondral junction variations in children that could mimic fractures. Design: 15-year retrospective study. Methods: Records of children aged Results: 123 children were excluded due to motion artifacts, trauma, being evaluated for more...