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Alternative Names:
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| Battered child syndrome; Physical abuse - children
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Symptoms:
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- Adult brings an injured child to an emergency room with an improbable explanation of the cause of the injury, or the injury is not recent
- Unusual and unexplained bone fractures
- Bruise marks shaped like hands, fingers, or objects (such as a belt), or unexplained bruises in areas where normal childhood activities would not usually result in bruising
- Specific patterns of scalding, seen when a child is immersed in hot water as a punishment -- particularly "glove" or "sock" burn patterns
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Burns from an electric stove, radiator, heater or other hot objects, usually seen on the child's hands, arms or buttocks
- Cigarette burns on exposed areas or the genitals
- Black eyes in an infant or a similar, unexplained injury in a child
- Human bite marks
- Lash marks
- Choke marks around neck
- Circular marks around wrists or ankles (indicating twisting or tying up)
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Separated sutures
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Bulging fontanelle
- Evidence of unexplained abdominal injury (such as bruised or ruptured intestines due to punching)
- Unexplained unconsciousness in infant
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Signs and tests:
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Text Continues Below
Typical injuries in abused children include:
- Bleeding in the back of the eye, seen with shaken baby syndrome or a direct blow to the head
- Internal damage, such as bleeding or rupture of an organ from blunt trauma
- Any fracture in an infant too young to walk or crawl
- Evidence of fractures at the tip of long bones or spiral-type fractures that result from twisting
- Fractured ribs, specially in the back
- Evidence of skull fracture (multiple fractures of different ages may be present)
- Subdural hematoma (collection of blood in the brain) without plausible explanation
- Multiple bruises of different ages, especially in unusual areas of the body (e.g., not the shins) or in patterns suggesting choking, twisting, or severe beating with objects or hands
- Other unusual skin damage, including burns or burn scars
The following tests can reveal physical injuries:
- Bone x-ray -- a skeletal survey is done whenever physical abuse is suspected. All the child's bones, including the skull, are x-rayed to look for undetected fractures or old, healing fractures.
- MRI or CT scan of the head or abdomen are done if there is a skull fracture, bleeding in the eye, unexplained vomiting, severe bruising of the face, skull or abdomen, or unexplained neurological symptoms, headaches, or loss of consciousness.
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