Her mother does not recall any accidents that would have produced these injuries. What are the possible causes of her injuries and what evaluations should be performed?

Her mother does not recall any accidents that would have produced these
injuries. What are the possible causes of her injuries and what evaluations should be performed?
Joanna is a 2-year-old who presents the urgent care clinic with a transverse fracture
of the right tibia. On examination she is withdrawn and cries when touched by anyone other than
her mother. On radiographs she has had a previous fracture of the right tibia and of the anterior
ribs on the left. Her mother does not recall any accidents that would have produced these
injuries. What are the possible causes of her injuries and what evaluations should be performed?

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