OI Link to Metaphyseal Fractures Remains Unclear

Review found only one confirmed classic metaphyseal fracture and supports continued evaluation for possible abuse

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A systematic review found only one radiograph meeting criteria for classic metaphyseal fractures in infants with osteogenesis imperfecta.
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The review included four studies with 11 patients, revealing significant limitations in definitions and image quality.
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No classic metaphyseal fractures were identified in over 500 children with osteogenesis imperfecta reviewed by the senior author.
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The strongest evidence for metaphyseal fractures came from a report on siblings with Bruck syndrome, a severe form of osteogenesis imperfecta.
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Classic metaphyseal fractures should be investigated for possible inflicted injury, even in confirmed cases of osteogenesis imperfecta.

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