Evaluating a bruise of possible abusive aetiology
Consult local guidance re: management of abuse.
A careful investigation of a child with an unexplained or inadequately explained bruise is important since in some cases the bruises may not be associated with abuse e.g. - underlying coagulopathies (1). During assessment (2);
- document the following
- location, number, size (two maximum diameters)
- petechiae if present
- history of cause (if any given)
- photograph relevant bruises, including a right angled measuring device and colour scale in the photo
- FBC, coagulation studies, von Willebrand Factor
- obtain a family/personal history of bleeding disorder
- if age is <2 years consider other occult injury e.g. - fractures, retinal haemorrhage, intracranial abnormality (1)
Reference:
- Maguire S. Which injuries may indicate child abuse? Arch Dis Child Educ Pract Ed. 2010;95(6):170-7.
- Dunstan FD, Guildea ZE, Kontos K, et al. A scoring system for bruise patterns: a tool for identifying abuse. Arch Dis Child. 2002 May;86(5):330-3.
Related pages
Create an account to add page annotations
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.