Which finding may indicate Shaken Baby Syndrome even when there are no obvious external injuries?

Which finding may indicate Shaken Baby Syndrome even when there are no obvious external injuries?

• A. Limb fractures
• B. Posterior rib fractures
• C. Visible facial bruising
• D. Hair loss

Answer: (B)

When injuries from shaking are considered, internal damage can reveal abuse even if the skin looks uninjured. Posterior rib fractures are a classic clue because the forces from shaking often transmit to the chest, causing fractures on the back of the ribs in infants. This pattern is more suggestive of abusive trauma than seen with simple accidental injuries, and it can be present without any obvious external injuries, making it the strongest indicator in this scenario. Limb fractures can occur in accidents or abuse but aren’t as specifically associated with shaking; visible facial bruising would be external and thus not align with “no obvious external injuries,” and hair loss isn’t a recognized indicator of Shaken Baby Syndrome.

When injuries from shaking are considered, internal damage can reveal abuse even if the skin looks uninjured. Posterior rib fractures are a classic clue because the forces from shaking often transmit to the chest, causing fractures on the back of the ribs in infants. This pattern is more suggestive of abusive trauma than seen with simple accidental injuries, and it can be present without any obvious external injuries, making it the strongest indicator in this scenario. Limb fractures can occur in accidents or abuse but aren’t as specifically associated with shaking; visible facial bruising would be external and thus not align with “no obvious external injuries,” and hair loss isn’t a recognized indicator of Shaken Baby Syndrome.