Social Peds

Question 1

Bruising red flags

Answer 1

• Non-mobile child “if you don’t cruise you don’t bruise”
• Mobile children:
• Patterned bruises
• Bilateral/symmetrical bruises
• Bruises that are unusually large or numerous
• Bruises that do not fit the mechanism described
• Location: ears, neck, chest, abdomen, back, buttocks, genitals, feet

Question 2

Fracture red flags

Answer 2

Fractures in non-mobile children

Location - higher specificity fractures include: Ribs
Long-bone metaphases (CMLs) Scapula
Sternum
Vertebral spinous processes

Multiple fractures
Fractures in different stages of healing

Question 3

Ddx of subdural hemorrhage

Answer 3

-Trauma: Birth, accidental, inflicted
-Coagulopathy: vWF disease, factor deficiencies (VIII, IX, XIII), plt problems, fibrinogen disorders, vitamin K deficiency
-Structural causes: AVM, aneurysms
-Neoplastic disease - brain tumor, leukemia
-Infectious - meningitis
-Genetic/Metabolic
Menkes disease, glutamic aciduria type I
-Benign enlargement of the subarachnoid space
(aka benign extra-axial fluid of infancy)

Question 4

Sentinel injuries

Answer 4

-A minor injury that is externally visible to caregivers or health care providers
-Most commonly bruises (80%) or intra-oral injuries
(10%)