PMC5832156_01
PMC5832156_02
PMC5832156_03
PMC5832156_04
PMC5832156_05
(A) Lower left leg x-ray shows a slipped epiphysis with migration of a thickened perichondrial ring (blue arrows), early periosteal reaction and callus. (B) Right rib films shows transverse fractures (blue arrows) of several right anterior ribs with cupping of the costochondral margins. (C) The distal right tibia shows a prominent perichondrial ring or spur (blue arrows). (D) Lateral skull film shows poor mineralization of the mid facial bones (f) and along the coronal sutures (c) with numerous posterior calvarial defects or craniotabes (*). (E) Right wrist film shows prominent perichondrial ring or spur (arrows) of the distal radius. There are also subtle Park-Harris lines in the distal radial metaphysis. (F) Lateral spine film shows non acute compression deformity of L2 vertebra (blue arrow). (G) There is a fracture in the mid shaft of the right clavicle; the left clavicle has a lucent hole, most likely an osteoid seam. The right clavicle appears as disorganized old callus. These presentations most likely occurred at birth and healed slowly and poorly.
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PMC5832156_05_kder-09-01-1279768-g001.jpg
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Skeletal survey reported the following 10 fractures: corner fracture at the distal tibial metaphyseal reaction, possible fracture of the anterior 3rd-7th ribs, compression fracture of L2 vertebral body, healing fractures of the right mid-clavicle and distal left clavicle, and a bucket handle type metaphyseal fracture of the distal right tibia (Fig. 1).