Rickets and Scurvy presenting in a Child as apparent Non Accidental Injury

The authors' report the case of an eleven month old Sudanese girl, who presented to the Accident and Emergency department with a femoral fracture. The fracture was apparently sustained following a minor, unsupervised fall. Subsequent radiographic imaging demonstrated changes which raised the concern of Non Accidental Injury. Only when a more detailed history was taken, and subsequent biochemical results became available was a diagnosis of nutritional rickets and scurvy made. Following appropriate orthopaedic management, and dietary supplementation, the child made a full recovery. We highlight the importance of underlying biochemical abnormalities as a differential diagnosis in fractures presenting as Non Accidental Injury (NAI).