History: 3-month-old infant with lethargy and an interhemispheric subdural hematoma on a head CT
Findings: Anteroposterior view of lower extremities from a skeletal survey reveals subtle iregularity of the distal tibia. Dedicated views of the left ankle reveal the classic metaphyseal ‘corner’ and ‘bucket handle’ fractures of the distal left tibia.
Discussion: The classic ‘metaphyseal corner’ and ‘bucket handle’ fractures are considered virtually pathognomonic of battered child syndrome and result from indirectly applied shearing forces during shaking. These fractures are often subtle, and the case presented reinforces the importance of following suspicious areas on skeletal surveys with dedicated high-quality radiographs. Shaken infants commonly prescient with seizures, lethargy, coma, retinal hemorrhages on findoscopic examination, and interhmispheric hematomas caused by rupture of bridging veins from the cerebral cortex to the superior saggital sinus.
Source: Aunt Minnie’s Atlas and imaging specific diagnosis (not images)