1655 Objectives Evaluate the pattern of trauma in child abuse cases in a Hispanic population. Methods Retrospective evaluation of records of pediatric patients referred to our clinic from 1999-2009 for bone scintigraphy (BS). BS were reviewed by two experienced nuclear medicine physicians, one with special pediatric nuclear medicine training. Skeletal survey (SS) was required in all cases for correlation to BS; head CT was available in 48% of the cases. Results Ninety cases were evaluated; 74% males, median age 9 months (1- 48 months), 79% less than I year old. The most frequent complaints were fall, head trauma, seizures, respiratory distress, hematomas and lacerations (65%). There was a high suspicion or confirmed child abuse by a relative in all cases. BS showed 263 lesions distributed in the skull, ribs, paraspinal region, scapula, clavicle, vertebra, pelvis and extremities. Lesions involved the ribs and skull in 60% of cases. Lesions in multiple body regions were identified in 50% of positive studies; more frequently located in the ribs-paraspinal region, skull femur, all of moderate to marked intensity. All patients with lesions in the paraspinal region, scapula, vertebra, pelvis and clavicle were less 1 year old. Twenty-eight percent of the lesions were not recognized in SS, mainly on ribs-paraspinal region, scapula, skull, pelvis and vertebra. CT showed intracranial bleeding and/or fractures in 88%; the BS showed lesions in 82%, more frequently on parietal region. Conclusions Child abuse in our population occurs at an earlier age and is frequently associated with severe skull and rib lesions. This pattern is worrisome when the long term outcome of patients is considered