OI X NAI P

“Our primary aim was to determine the radiographic differences between fractures in pediatric patients with OI and routine fractures in patients with normal bone quality. We found that oblique, transverse, diaphyseal, and bilateral long-bone fractures were more common in patients with OI, whereas buckle, metaphyseal, and physeal fractures were more common in patients with normal bone quality. These findings were consistent in patients with type-1 OI, except for transverse and buckle fracture rates, which did not differ significantly from those of patients without OI. Fractures associated with the greatest increase in OI likelihood were diaphyseal humerus, olecranon, and transverse fractures of the humerus, tibia, and fibula. Physeal and supracondylar humerus fractures were associated with the greatest decrease in OI likelihood.


Although non-accidental injuries (NAI) are more common in cases of unexplained fractures than rare disorders such as osteogenesis imperfecta (OI), ruling out OI and other medical causes of fracture is always indicated. The majority of OI patients can be diagnosed with the help of family history, physical examination, and radiographic findings. In particular, there are a few radiological findings which are seen more commonly in NAI than in OI which may help guide clinician considerations regarding the probability of either of these diagnoses. At the same time, molecular testing still merits careful consideration in cases with unexplained fractures without obvious additional signs of abuse.