Joanna is a 2-year-old who presents at 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 On examination, she is withdrawn and cries when touched by anyone other than her mother.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.
Answer the following question about Joanna’s condition.
1. What are the possible causes of Joanna’s injuries?
2. What evaluations should be performed?
3. If Joanna is diagnosed with osteogenesis imperfecta, how should she be treated?



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