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Widespread misunderstanding of infantile rickets, even among experts in the field

Posted on: November 15, 2017   by  John Cannell, MD

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Finally, the medical establishment may be wakening to the fact that tens of thousands of Americans are not child abusers.

I have frequently written about the travesty of justice perpetrated by the pediatricians operating under the protection of the Committee on Child Abuse and Neglect of the American Academy of Pediatrics. This committee has churned out garbage abuse papers, one after another.

Their papers on rickets display an ignorance of vitamin D that is truly egregious. At the heart of the matter is their bold claim, first made in the 1980’s, that any child with multiple fractures was abused. See, the 80’s was the first time modern medicine even knew that multiple fractures occur in infants. So, when first identified, it was called infantile idiopathic metabolic bone disease. This was an excellent name.

“No!”, shrieked the abuse pediatricians. These physicians were certain that abusive parents were causing these infantile fractures. So, they lobbied for idiopathic metabolic bone disease with multiple fractures in infants to be discarded, and they twisted that diagnosis to child abuse. Increasingly, scientists realize these infantile fractures are more commonly caused by metabolic bone disease such as rickets or Erhlos Danlos syndrome (a syndrome of abnormal flexibility and fractures).

Here is a case report of an infantile fracture (spiral fracture of tibia) which was eventually diagnosed as rickets, not abuse.

Kaushal S, Raisingani M, David R, Shah B. Spiral Fracture in Young Infant Causing a Diagnostic Dilemma: Nutritional Rickets versus Child Abuse. Case Rep Pediatr. 2017;2017:7213629.

Unfortunately, neither the authors or the editor (Alberto Spalice) is careful to critically evaluate the assumptions made in the child abuse literature.

For example, the authors write,

“Non-accidental injury is responsible for most fractures in children less than two years of age.”

This is a false statement.  What should be said is that almost all fractures in infants have traditionally been diagnosed as abuse.  However, the diagnostic procedures used by child abuse pediatricians to arrive at this conclusion are bogus and use circular logic: How do you know the infant was abused? “Because he has fractures.”  Why does he have fractures? “Because he was abused.” This logic has removed thousands of infants from their parents and falsely labeled thousands of parents as child abusers.

The authors write,

“The psychosocial assessment in conjunction with lack of additional physical findings ruled out child abuse.”

This statement should be true, but the sad fact is that the abuse “specialists” frequently disregard both the psychosocial assessment of the parents and the fact that no other evidence of abuse is found, except for the fractures.

Finally, the authors write,

“Spiral fractures while commonly caused by non-accidental injury (child abuse), can also rarely be caused by rickets.”

The truth is no one knows what causes these fractures. Just because the child abuse “experts” claim the fractures are a result of abuse does not make it true. Also, the abuse experts no longer talk about this, but for years, believe it or not, the dogma was that the abuser twirled the infant around the room by their feet, causing a spiral fracture. This alleged twirling strikes me as ludicrous.

Finally, the authors and the editor furthered the falsehood that radiology is the gold standard for diagnosing rickets. As Professor Michael Holick and I clearly showed, radiology misses infantile rickets about 70% of the time compared to cases discovered by a bone biopsy.

After publication, three abuse pediatricians wrote in, trying to strong arm the editor to withdraw the paper. They told him if he published it, it would be the first time the journal published two cases of child abuse.  The editor would not budge and he published the paper. The three pediatricians, after reading our response to their letter, withdrew their letter.

Cannell JJ, Holick MF. Multiple unexplained fractures in infants and child physical abuse. J Steroid Biochem Mol Biol. 2016 Sep 15.

This travesty is not going away anytime soon. It is hard to stand up to them; they make sure you feel like you’re aiding and abetting child abuse.

Finally, I want to give a shout out to Professor Michael Holick. He has served as an expert witness for more than 500 of these cases, dating back a number of years.  Do you know how many times he billed the parents?  Zero, he is a truly remarkable man.

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