Rare Differential Diagnoses in Cases of suspected Child Abuse

Various (rare) bone diseases can feature findings that resemble abnormalities after child abuse. The first case study describes a 9-month-old infant with nonspecific, ubiquitous skeletal anomalies. The second describes a 1.5-year-old girl with a linear fracture of the tibia and nonspecific deformities of the fibula. The conspicuous radiological findings in the cases presented led to the involvement of forensic medicine and youth welfare officers owing to suspected child endangerment. This results in far-reaching consequences for the affected families, often with the potential for criminal prosecution, the breakdown of family social structures, and enormous psychological strain for those affected. Finally, the diagnoses of vitamin D deficiency rickets and congenital pseudarthrosis of the tibia were confirmed, two rare differential diagnoses in cases of suspected child abuse. To avoid victimization, clarifying information on the differential diagnoses of nonaccidental injuries and the importance of interdisciplinary assessment is urgently required.