I read with great interest Dr Sprigg's thoughtful editorial in a recent issue of this journal.1 Much of what he says about temporary brittle bone disease (TBBD) is true. We still do not know its cause or causes. We still have no specific diagnostic tests. We cannot exclude other causes of fractures in every one of our published cases.

However, between 1985 and 2000 I prepared reports for civil litigation on 85 children with unexplained fractures whose cases were so similar to each other that it appeared likely that a distinctive disorder or group of disorders was responsible. Non-accidental skeletal injury seemed unlikely since there was a gross discrepancy between the radiological evidence of injury and the …