A 3 year old male presents to the ER with a gross deformity of his left upper arm. His mother reports that her son "slipped while taking a bath" and struck his arm on the side of the tub. He has a history of a previous right femur fracture that resulted from a fall down the stairs one year ago. In addition to the gross deformity to the left humerus, his physical exam is notable for bluish sclera and no other signs of trauma (no bruising or scars).
A skeletal survey is ordered by the then attending doctor, who thought that the injury did not fit the history provided by the parent. The plain films reveal a comminuted fracture in the middle of the left humerus, and signs of multiple healed rib fractures in addition to the healed right femur fracture. The ER physician notified child helpline as recommended by other doctors. The second assessment of child and parent by affiliated…
