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Non-accidental injury in an infant — RCPSC EM MCQ

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HardTraumaNon-accidental injury in an infantRCPSC EM

CTAS 2: A 5-month-old is brought for irritability after a reported short fall from a couch. Vitals are stable. Exam shows bruising on the ears and trunk; CT head shows subdural haemorrhage of different densities. Skeletal survey shows healing posterior rib fractures. What is the most likely diagnosis?

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Correct answer: C — Inflicted injury

Inconsistent mechanism, patterned bruising in non-mobile infant, subdural blood of different ages and posterior rib fractures are highly concerning for inflicted injury. Child protection and admission are required.

Reference: Canadian Paediatric Society child maltreatment guidance; Royal College EM Objectives