The medical assessment of bruising in suspected child maltreatment cases: A clinical perspective

Abstract

The recommendations in this document do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate. All Canadian Paediatric Society position statements and practice points are reviewed on a regular basis. Retired statements are removed from the website. Please consult the Position Statements section of the CPS website (www.cps.ca) for the full-text, current version.

Caffey’s disease in disguise: a child abuse mimic

“…Red flags of physical abuse include unexplained bruises, fractures or swellings in a child whose clinical history cannot be entirely accounted for by the stated condition 1. Medical disorders resembling child abuse viz underlying bleeding tendencies, connective tissue disorders with bony fragility like osteogenesis imperfecta, scurvy and Ehler-Danlos syndrome should be evaluated prior to making the diagnosis of abuse 2 3. This report presents an infant with unexplained right-hand swelling, initially thought to be child abuse but later diagnosed as Caffey disease.…”

Prevalence, Risks and Prevention of Child Maltreatment in the Middle East

“…The physical injuries from maltreatment adversely impact the wellness paradigm of the affected children [61]. Physical abuse increases the risk and incidence of several clinical complications including subdural hemorrhage, brain trauma, burns, and bruises in the pediatric population [23,[62][63][64]. The complications from shaken baby syndrome/abusive head trauma, skeletal injuries, sexual abuse, and neglect often lead to growth failure, dental caries, malnutrition, scapular/spinal/sternal fractures, and hematuria.…”