ABSTRACT
This chapter presents a number of conditions that more or less mimic the radiological manifestations of nonaccidental trauma. The most commonly, and ordinarily the first, mentioned metaphyseal lesions as mimickers of physical abuse are scurvy and rickets. Bowing of long bones, such as saber shin, is a typical feature in older victims. Congenital syphilis seen originally as a skeletal lesion can easily be mistaken for child abuse. Growth plates subject to ischemic damage display substantial alterations in both epiphyses and metaphyses that persist for years and may be confused with physical trauma if examined singularly and without the pertinent past history. Leukemia is the most common childhood malignancy. The most common type of childhood leukemia is acute lymphoblastic leukemia. Radiographic findings include diaphyseal periosteal reaction and metaphyseal spurring suggestive of trauma. The subperiosteal new bone production in scurvy is secondary to subperiosteal bleeding, which may be spontaneous or to trauma inflicted on these sickly, irritable children.
