Differential diagnosis of child physical abuse: conditions that may be mistaken for child abuse |
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| Affiliation: | 1. Department of Emergency Medicine, UMass Chan Medical School, Worcester, MA;2. Department of Emergency Medicine, Ronald Reagan – University of California, Los Angeles Medical Center, Los Angeles, CA;3. Antelope Valley Hospital, Lancaster, CA;4. Department of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco, CA;1. Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia;2. School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia;3. Australian Centre for Health Law Research, School of Law, Queensland University of Technology (QUT), Australia;4. Parenting and Family Support Centre, University of Queensland, Australia;5. Department of Human Development and Family Studies, The Pennsylvania State University, USA;6. Department of Pediatrics, The Pennsylvania State University College of Medicine, USA;7. Bloomberg School of Public Health, Johns Hopkins University, USA;1. NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn NY, USA;2. NewYork-Presbyterian Queens Hospital, Flushing NY, USA;1. Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah;2. Intermountain Healthcare, Salt Lake City, Utah |
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| Abstract: | ![]()
Child protection is one of the most difficult aspects of paediatric practice. Physical abuse is the commonest form of maltreatment identified by clinicians. Suspicious injuries are rarely accompanied by an admission of inflicted harm, even when this is the cause. Clinicians therefore must have a high index of suspicion and where injuries appear consistent with physical abuse or are inadequately explained they must follow safeguarding procedures. However, as for any clinical problem, there is a differential diagnosis to consider. Medical conditions can sometimes mimic signs suggestive of physical abuse. Other conditions can increase a child's vulnerability to specific injuries. In this article we discuss the differential diagnosis of bruising, fractures and head injuries which are the three commonest presenting features of physical abuse. Awareness of the differential diagnosis and appropriate assessment of the injured child can assist in reaching the correct diagnosis and therefore protect children from harm. |
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| Keywords: | bruises head injury child maltreatment physical abuse mimics |
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