Differential diagnosis of child physical abuse: conditions that may be mistaken for child abuse. Issue 3 (March 2023)

• Record Type: Journal Article
• Authors: Morris, Helen; Debelle, Geoff
• Is Part Of: Paediatrics and child health. Volume 33:Issue 3(2023)
• Page Start: 78
• Page End: 83
• Publication Date: 2023-03
• Subjects: bruises head injury -- child maltreatment -- physical abuse mimics; Pediatrics -- Periodicals; Pediatrics -- Periodicals; Pédiatrie -- Périodiques; 618.920005
• DOI: 10.1016/j.paed.2022.12.009
• Languages: English
• ISSNs: 1751-7222

Abstract

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.