A 10-month-old febrile boy was discharged from the accident and emergency (A&E) department after assessment that included a chest x-ray. Five days later, the A&E consultant received a radiologist's report describing possible healing rib fractures. A second radiology opinion agreed that appearances suggested old fractures of ribs 7, 8 and possibly 9 on the right and advised a skeletal survey. The on call consultant paediatrician and named child protection paediatrician were informed immediately. The skeletal survey was reported as normal. The opacities noted 5 days earlier (figure 1) were not apparent on the second chest x-ray (figure 2). Oblique views confirmed no rib fractures. It was then clarified with the parents and social services that there was no child protection issue.
展开▼
