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Radiological Case of the Month

Jacob Zeiss, MD; Nathaniel D. Wycliffe, MD; Bernard J. Cullen, MD; Steven Conover, MD; Beverly P. Wood, MD
Am J Dis Child. 1988;142(12):1367-1368. doi:10.1001/archpedi.1988.02150120121054.
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An 8-year-old boy with a history of severe mental retardation, cerebral palsy, and seizure disorder was brought to the emergency room because of a lump in the anterior aspect of upper right side of the chest. His mother denied any history of trauma, other than a fall from a wheelchair while he was on the school bus. Initial roentgenograms showed a healing fracture of the right clavicle (Fig 1). A healing fracture involving the right distal shaft of the ulna was noted by radiographic long-bone skeletal survey (Fig 2). No history of trauma explained the ulnar fracture. Child abuse was suspected, and the child was admitted to the hospital.

Significant history included a normal birth and neonatal period. At 6 weeks of age the patient was the victim of a house fire and received severe burns. Secondary to anoxia he developed seizures, cerebral palsy, and developmental delay. At the time


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