From the U.S. Surgeon General:

"The possibility of congenital disorders should be considered when children fracture, especially with little trauma."*

* From Bone Health & Osteoporosis, A Surgeon General Report, page 191. 


Osteogenesis imperfecta (OI) is characterized by bones that break easily. A minor accident may result in a fracture; some fractures may occur while a child is being diapered, lifted, or dressed. It is possible for a person with OI to break a bone without being aware of it. Children who are not diagnosed at birth often suffer a series of painful fractures before health care professionals are able to diagnose the condition.

Child abuse is also characterized by broken bones. In recent years, Americans have become increasingly aware of this problem and major efforts have been undertaken to protect children. Child abuse is a pattern of behavior that often is passed down from one generation to the next. Many abusive parents were themselves abused as children. Open, honest discussion of the issue not only can ensure the safety of countless children but can also encourage parents who wish to break the cycle of abusive behavior to seek the help they need.

"Health care professionals working in emergency room departments and orthopedic practices also have an important role. They must recognize that many bone fractures signal the potential for bone disease, and go beyond fixing patient's bones by referring them, when appropriate, to another health care professional for further assessment of the potential of bone disease."*

* From Bone Health & Osteoporosis, A Surgeon General Report, page 351. 







Diagnosis: OI or Child Abuse?

False accusations of child abuse may occur in families with children who have milder forms of OI and/or in whom OI has not previously been diagnosed. Types of fractures that are typically observed in both child abuse and OI include:

  • fractures in multiple stages of healing
  • rib fractures
  • spiral fractures
  • fractures for which there is no adequate explanation of trauma.


"In some cases, especially in fractures in infants, referrals to a pediatric specialist who deals with metabolic bone disease will be necessary."*

* From Bone Health & Osteoporosis, A Surgeon General Report, page 260.


Read our Fact Sheets on this issue:

Is This An Abused Child?

      OI Issues: Child Abuse

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