Differential Diagnosis for a 2-year-old who fell down 6 steps
- Single most likely diagnosis:
- Minor head trauma or bruising: This is the most likely diagnosis given the age of the child and the relatively short distance of the fall. Most children who fall from a short distance tend to have minor injuries.
- Other Likely diagnoses:
- Fracture (e.g., clavicle, humerus, or wrist): Given the mechanism of injury, it's possible the child could have fractured a bone, especially if they landed on an outstretched hand or directly on a limb.
- Soft tissue injury (e.g., sprain, strain): The child could have injured muscles or ligaments, particularly if the fall involved twisting or bending.
- Concussion or mild traumatic brain injury: Although less common with shorter falls, the possibility of a concussion should be considered, especially if the child hit their head.
- Do Not Miss diagnoses:
- Intracranial hemorrhage or severe head injury: Although less likely, a severe head injury could occur, especially if the child's head struck a hard surface or object during the fall. This is a critical diagnosis not to miss due to its potential for severe consequences.
- Spinal cord injury: Though rare in short falls, any trauma to the spine could potentially lead to serious neurological deficits, making it crucial to assess for spinal injury.
- Internal injuries (e.g., spleen or liver laceration): Internal injuries can occur from blunt trauma and might not be immediately apparent, making them critical not to miss.
- Rare diagnoses:
- Basilar skull fracture: A fracture at the base of the skull, which could occur from a fall but is less common in short-distance falls.
- Cervical spine fracture or dislocation: While rare in children due to their flexible spines, any fall from a height poses a risk of cervical spine injury.
- Child abuse: In any case of injury in a child, it's essential to consider the possibility of non-accidental trauma, especially if the history provided does not match the injury pattern or severity.