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Radiological “bone within a bone” appearance with atraumatic fractures
  1. T van den Broek1,
  2. S Bulk2,
  3. J E H Pruijs3,
  4. F J A Beek4
  1. 1
    Department of Pediatrics, University Medical Center, Utrecht, The Netherlands
  2. 2
    Department of Medical Genetics, University Medical Center, Utrecht, The Netherlands
  3. 3
    Department of Pediatric Orthopaedics, University Medical Center, Utrecht, The Netherlands
  4. 4
    Department of Pediatric Radiology, University Medical Center, Utrecht, The Netherlands
  1. 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{at}umcutrecht.nl

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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 …

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