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BIRTH TRAUMA: CLAVICULAR FRACTURE
Authored By: kwinkl01 and Keith Fischer.
Patient: 1 month 8 day old male
History: 1 month 8 day old male patient with fever of unknown origin. Left subclavian central venous catheter.
Image Size:[small][as-submitted]

Fig. 1
bone scintigraphy

Fig. 2
computed tomography

Fig. 3
chest radiograph
Image Size:[small][as-submitted]

Findings:

BONE SCINTIGRAPHY (WHOLE-BODY)

RADIOPHARMACEUTICAL: 2.3 mCi Tc-99m MDP i.v.

 

Delayed whole-body scintigrams were obtained.

 

There is a single focus of increased tracer localization about the left clavicle. Otherwise, there is normal distribution of activity throughout the skeleton.

 

COMPUTED TOMOGRAPHY

Left clavicular fracture, with associated callus formation.

 

CHEST RADIOGRAPH

Left clavicular fracture, with associated callus formation.

Diagnosis: Healing left clavicular fracture.
General Discussion:

HISTORY

5-week-old male patient with failure to thrive and fever of unknown origin. Left clavicular fracture at birth.

 

DIFFERENTIAL DIAGNOSIS: Localized bone scintigraphy uptake (Mettler, 2006)

trauma

degenerative changes (arthritis)

infection

primary bone tumor (benign and malignant)

metastatic disease

Paget's disease, fibrous dysplasia

hyperemia

overlying soft tissue activity

decreased overlying soft tissue (decreased attenuation)

 

DISCUSSION: Incidence of Birth Trauma (Borna, 2010)

The incidence of birth trauma was 41.16 per 1,000 vaginal deliveries. Among the 148 infants with birth trauma, nine had multiple injuries. The most common injury was cephalohematoma (n = 77). Other injuries included clavicle fractures (n = 56), brachial plexus paralysis (n = 13), asphyxia (n = 7), facial lacerations (n = 4), brain hemorrhage (n = 1), and skin hematoma (n = 2).

References:

H Borna, SMBA Rad, S Borna, and SM Mohseni, Incidence of and Risk Factors for Birth Trauma in Iran, Taiwanese Journal of Obstetrics and Gynecology Volume 40, Issue 2 (2010), pp. 170-173.

 

Mettler, Fred and Milton Guiberteau. Essentials of Nuclear Medicine Imaging. 5th ed. Philadelphia, PA: Saunders Elsevier, 2006, pp 244.

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Additional Details:

Case Number: 270894Owner(s): kwinkl01 and Keith FischerLast Updated: 02-07-2013
Anatomy: Skeletal System   Pathology: Trauma
Modality: CT, Conventional Radiograph, Nuc MedAccess Level: Readable by all users, writable by NucMed Certifiers
Keywords: bsnm; 4.41

Case has been viewed 30 times.
Certified by Keith Fischer on 06-10-2011

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