Fig. 9. Epiphyseal-metaphyseal fractures as seen in shaken baby syndrome: stages of healing. A. Fresh fracture (less than 10 days). Note rarefaction of the bone underneath the epiphyseal plate (short arrow). B. Appearance of fracture at 10 days to 2 weeks. Note early periosteal new bone deposition (long arrows). C. Appearance of fracture at 2 to 4 weeks. Note more pronounced periosteal new bone deposition and epiphyseal-metaphyseal changes characteristic of this stage of healing. (Swischuk LE: Radiology of the skeletal system. In Ellerstein NS [ed]: Child Abuse and Neglect: A Medical Reference. New York, John Wiley Sons) |