NCJ Number
111205
Date Published
1987
Length
19 pages
Annotation
Suggestions for physicians in diagnosing nonaccidental trauma in children covers the interpretation of parental accounts of injuries; distinguishing between accidental and inflicted bruises; diagnosing inflicted eye injuries, head injuries, and abdominal injuries; immediate actions to be taken by the physician; and the medical evaluation of children with physical abuse.
Abstract
Some aspects of histories of inflicted injuries offered physicians by parents are eyewitness history, unexplained and implausible history, alleged self-inflicted injury, alleged sibling-inflicted injury, and delay in seeking medical care. The discussion of inflicted bruises covers typical sites, human hand marks, human bite marks, strap marks, and bizarre marks. The paper also notes aspects of accidental bruises, unusual bruises, and pseudobruises. After providing diagnostic guidelines for detecting inflicted eye injuries, head injuries, and abdominal injuries, the paper advises that upon concluding that a child has been physically abused, the physician should report the case to child protective services, hospitalize the child during the initial evaluation period, and tell the parents the diagnosis. The medical evaluation should encompass a history of the injury, a physical examination, a trauma X-ray survey, a bleeding disorder screen, color photographs, physical exam for siblings, a written medical report, behavioral screening, and developmental screening. Appended sample medical report, 30 references.