Not everything is child abuse

When an infant presents in the emergency room with a single bone fracture, almost immediately the parents or caretakers become suspected of child abuse. This can lead to awkward problems of false accusation. The trouble stems from the fact that we have become so sensitized to child abuse that often we forget to consider other possible explanations for a fracture. This paper deals with this difficulty and discusses entities such as birth trauma, fractures in metabolically weakened bones, fractures through dysplastic bones, the 'pulled elbow', and hematologic disease.