Paediatric: non-accidental injury: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric: non-accidental injury

Sample item

A 7-month-old infant has multiple fractures of different ages with posterior rib fractures and a metaphyseal corner fracture. What is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Non-accidental injury (child abuse)

Metaphyseal corner (bucket-handle) fractures, posterior rib fractures, multiple fractures of differing ages and fractures in non-ambulatory infants are highly specific for abuse. A skeletal survey, ophthalmology review and child protection referral are needed.

Option by option

  • A. Scurvy

    Scurvy produces subperiosteal haemorrhage but not this pattern.

  • B. Non-accidental injury (child abuse) (correct)

    Correct. This pattern is highly suggestive of abuse.

  • C. Normal handling

    Normal handling does not cause such fractures.

  • D. Osteogenesis imperfecta only

    Osteogenesis imperfecta must be considered but these fracture types are specific for abuse.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Non-accidental injury (child abuse). Metaphyseal corner (bucket-handle) fractures, posterior rib fractures, multiple fractures of differing ages and fractures in non-ambulatory infants are highly specific for abuse.

Why is "Scurvy" not the answer?

Scurvy produces subperiosteal haemorrhage but not this pattern.

Why is "Normal handling" not the answer?

Normal handling does not cause such fractures.

Why is "Osteogenesis imperfecta only" not the answer?

Osteogenesis imperfecta must be considered but these fracture types are specific for abuse.

What concept does this question test?

It tests Paediatric: non-accidental injury in Orthopaedics. A skeletal survey, ophthalmology review and child protection referral are needed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric: non-accidental injury?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.