A mother and her 3 month old son present to their local physician for what the mother believes is decreased arm movement and pain when moving her son’s arms. Initial imaging of the boys arms revealed bilateral radial fractures and associated lytic bony lesions (Figure 1). Clinically child abuse was an initial concern. A follow up skeletal survery, along with an ophthalmology consult, was performed to assess for further child abuse related injuries. Skeletal survery revealed bilateral, medial tibial lytic lesions (Figure 2). Biopsy was performed of the right sided tibial lesion and showed a mixed lymphohistiocytic infiltrate with associated fibrosis (Figure 3).Figure 1 Figure 2 Figure 3
|Casey Gleue, M.D.
Resident, Anatomic and Clinical Pathology
|Jorge Torres-Mora, M.D.
Consultant, Anatomic Pathology
Assistant Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine and Science