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CML – most specific for NAI — RACP Paediatrics MCQ

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HardEmergencyCML – most specific for NAIRACP Paediatrics

An 8-month-old non-mobile infant presents with a long bone fracture. Which type of long bone fracture is most specific for non-accidental injury?

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Correct answer: C — Classic metaphyseal corner fractures

Classic metaphyseal lesions (CMLs), also known as corner fractures or bucket-handle fractures, are the fracture pattern most specific for NAI. They result from traction/torsional forces on the limb and are pathognomonic for inflicted injury in infants. They are often occult and detected only on skeletal survey. They should prompt a full child protection assessment.

Reference: RCH Melbourne – 2023 – Child Abuse CPG; RACP Paediatric Curriculum – Child Protection