{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T00:11:26Z","timestamp":1783210286551,"version":"3.54.6"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"\n Objective<\/jats:title>\n The primary objective of this study was to determine the prevalence of (a<\/jats:italic>) additional injuries, (b<\/jats:italic>) abuse as determined by a standardized scale, and (c<\/jats:italic>) reports to child protective services (CPS) among children younger than 5 years in whom a rib fracture was the first presenting injury concerning for abuse.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective study of children younger than 5 years diagnosed with rib fractures at a tertiary pediatric hospital between 2007 and 2018 was performed. Children in motor vehicle crashes, hospitalized after birth, or with previously diagnosed metabolic bone disease were excluded. We included only those children whose rib fractures were the first presenting injury. Demographic and clinical information was abstracted from the records. Prevalence of additional injuries, a diagnosis of abuse, and a report to CPS were calculated. Associations between patient demographic and clinical characteristics and the outcomes of interest were examined.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 67 cases included, additional injuries concerning for abuse were identified in 40 (60%), and 58% were deemed likely or definite abuse. Reports to CPS were filed in 72% of cases. Posterior rib fractures, multiple rib fractures, and presence of rib fractures of multiple ages were all associated with presence of additional injuries and classification as definite or likely abuse (all P<\/jats:italic> \u2264 0.05).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The presence of a rib fracture in young children is associated with a high likelihood of additional concerning injuries and should prompt a thorough evaluation for child abuse.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000002071","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T10:26:43Z","timestamp":1584700003000},"page":"e1451-e1456","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Prevalence of Abuse and Additional Injury in Young Children With Rib Fractures as Their Presenting Injury"],"prefix":"10.1097","volume":"37","author":[{"given":"Brian","family":"Brennan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Katherine","family":"Henry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Altaffer","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne N.","family":"Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.chiabu.2017.11.008","article-title":"Abusive fracture incidence over three decades at a level 1 pediatric trauma center","volume":"76","year":"2018","journal-title":"Child Abuse Negl"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"e477","DOI":"10.1542\/peds.2013-3793","article-title":"Evaluating children with fractures for child physical abuse","volume":"133","year":"2014","journal-title":"Pediatrics"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1542\/peds.2007-1959","article-title":"Incidence of fractures attributable to abuse in young hospitalized children: results from analysis of a United States database","volume":"122","year":"2008","journal-title":"Pediatrics"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/PEC.0000000000000911","article-title":"Prevalence of abuse among young children with rib fractures: a systematic review","volume":"35","year":"2019","journal-title":"Pediatr Emerg Care"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1001\/jama.288.13.1603","article-title":"Racial differences in the evaluation of pediatric fractures for physical abuse","volume":"288","year":"2002","journal-title":"JAMA"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/BLO.0b013e31805c0849","article-title":"What factors affect the identification and reporting of child abuse-related fractures?","volume":"461","year":"2007","journal-title":"Clin Orthop Relat Res"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1556-4029.2008.00922.x","article-title":"Postmortem skeletal survey practice in pediatric forensic autopsies: a national survey","volume":"54","year":"2009","journal-title":"J Forensic Sci"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1542\/peds.2015-1487","article-title":"Testing for abuse in children with sentinel injuries","volume":"136","year":"2015","journal-title":"Pediatrics"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"a1518","DOI":"10.1136\/bmj.a1518","article-title":"Patterns of skeletal fractures in child abuse: systematic review","volume":"337","year":"2008","journal-title":"BMJ"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.jpeds.2018.08.067","article-title":"The prevalence of rib fractures incidentally identified by chest radiograph among infants and toddlers","volume":"204","year":"2019","journal-title":"J Pediatr"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1007\/s00247-014-2988-y","article-title":"Frequency of intrathoracic injuries in children younger than 3 years with rib fractures","volume":"44","year":"2014","journal-title":"Pediatr Radiol"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","year":"2009","journal-title":"J Biomed Inform"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.chiabu.2006.07.004","article-title":"Are abusive fractures in young children becoming less common? Changes over 24 years","volume":"31","year":"2007","journal-title":"Child Abuse Negl"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","year":"1977","journal-title":"Biometrics"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:03:06Z","timestamp":1746388986000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,20]]},"references-count":14,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002071","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3,20]]}}}