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[black small square] In your article "How to Recognize and Respond to Child Abuse" (October 2004), you noted that spiral fractures in children are a telltale sign of physical abuse. I wonder if you've ever published information on osteogenesis imperfecta (OI).

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When my grandson had a fracture at age 6 months, my daughter was accused of child abuse. With much assistance from the Department of Children's Services caseworker, he was referred to a children's hospital for further evaluation. There we learned he had OI, a genetic defect that causes bones to break too easily, sometimes for no apparent reason. He's 5 now and has had six fractures-both femurs, ankle, clavicle, L1, and midthoracic.


Health care workers should know the signs of OI, such as sclera with a blue, purple, or gray tint, and a tendency to spinal curvature. Families accused of child abuse may find that their child suffers from OI.




Dresden, Tenn.


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