TBBD is a recently described bone disorder characterized by multiple, unexplained fractures [MUF] during the first year of life in which there is no apparent biochemical abnormality in bone metabolism [Am. J. Med. Gen. 45:187-92]. Recognition of TBBD is important for it can be mistaken for child abuse. We have found a strong association between TBBD and DFM from IUC. CT bone density measurements of cortical bone density [CBD] and trabecular bone density [TBD] in 5 TBBD infants with DFM/IUC and in 7 control infants are shown in the Figure. The results are expressed in the#SD from over 1,000 normal adults [Z-score] (+=control infants, *=TBBD; p<.05 for + versus *). The results suggest that CT bone density measurements may be useful in distinguishing child abuse from intrinsic bone disease in cases of MUF and that DFM/IUC is associated with decreased bone density.

figure 1