Snapshot A 4-year-old girl falls down on the playground and is rushed to the emergency room. Her work-up reveals a new fracture in her right tibia, as well as multiple old fractures in her bilateral arms and legs at various stages of healing. Her physician is concerned about child abuse, but communication with the girl’s pediatrician reaveals her condition. On exam, her sclera are blue. Introduction Defect in production of type I collagen causing abnormal, fragile bones that fracture easily Most commonly autosomal dominant login to view 1 more bullet Also known as “brittle bone disease” Pathogenesis login to view 6 more bullets Often confused with child abuse Presentation Symptoms login to view 3 more bullets Physical exam login to view 5 more bullets Evaluation Diagnosis made by clinical and radiographic findings (skeletal survey) Confirmed with DNA (blood or saliva) or protein testing (skin biopsy) Differential Non-accidental injury Idiopathic juvenile osteoporosis Treatment Bisphosphonates to increase bone mineral density Prognosis, Prevention, and Complications Prognosis login to view 2 more bullets Prevention login to view 2 more bullets Complications login to view 3 more bullets