The investigation of any unexplained infant death must include a full skeletal survey to detect any possible trauma, especially trauma resulting from possible child abuse. The authors describe the case of a 4-month old male infant who was found unresponsive in his crib and died 4 days after hospitalization. During his hospitalization he was diagnosed by radiography with a fracture of the third lumbar vertebra. It was at first presumed to be abusive in nature. However, autopsy examination failed to discover the presence of a fracture. Instead, a defect in the development of the vertebral bodies was discovered. The diagnoses shifted to a possible failure of the notochord to regress. After a full investigation, the death was ruled as sudden infant death syndrome; all autopsies were negative for child abuse trauma. The authors present this case study as a cautionary tale against the overzealous identification of any spinal abnormality as resulting from child abuse. References