Abuse
When to suspect abuse
When to suspect abuse
- Suspect in atypical, pediatrics, elderly
- Absent or vague explanation, inconsistent story, history non-compatible with injury
- Delay in seeking medical attention
- Lesion/explanation non-compatible with child's age (eg. younger than 10 months with bruises, bruises on abdomen/thorax/buttocks, fractures in non-ambulatory children)
- Failure to thrive, dental caries
- Metaphysis fracture (bucket handle)
- Posteromedial rib fractures
- Fracture of different ages
- Shaken-baby syndrome (subdural hematoma, cerebral edema, retinal hemorrhages)
- Apathy of caregiver/patient
- Geometric lesions
References:
- AAFP 2013. Abuse. http://www.aafp.org/afp/2013/1115/p669.html