IMAGES IN MEDICINE
Radiological "bone within a bone" appearance with atraumatic fractures
1 Department of Pediatrics, University Medical Center, Utrecht, The Netherlands
2 Department of Medical Genetics, University Medical Center, Utrecht, The Netherlands
3 Department of Pediatric Orthopaedics, University Medical Center, Utrecht, The Netherlands
4 Department of Pediatric Radiology, University Medical Center, Utrecht, The Netherlands
Correspondence to:
Correspondence to Mr T van den Broek, University Medical Center Utrecht, Wilhelmina Children’s Hospital, Lundlaan 6 (Room KE 04.1331), 3584 EA Utrecht, The Netherlands; T.vandenbroek@umcutrecht.nl
Keywords: bone within a bone
| The first 150 words of the full text of this article appear below. |
Case report
A 6-year-old boy presented with progressive pain in the right groin for a couple of months. Physiotherapy was initially started because of no apparent trauma, but did not deliver any relief. An x-ray examination of the hip showed a Salter–Harris type 2 fracture of the femoral neck without any callus formation (fig 1). The medical history consisted of fractures in the hands and feet. On physical examination, a head circumference +2.5 standard deviations of the mean was noticed. Bone density was assessed by dual-energy x-ray absorptiometry scan and was 10 standard deviations above the mean for the patient’s age for both the lumbar spine and both hips. Radiographs confirmed the increased bone density and showed a typical "bone within a bone" appearance in both hands (fig 2) and feet.
Figure 1 Radiograph of the hip showing a Salter–Harris type 2 fracture of the right femoral neck | |||||||||
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