Clinical features

The features of physical abuse may be nebulous, and sadly the health care professional must maintain a high index of suspicion in all children where an injury has occured.

Features include:

• bruising
• fractures
• burns or scalds
• bites
• the child may be afraid of a certain person, or of everyone

An important feature of physical child abuse is the history. Features include:

• inconsistent history - from one telling to the next, or from one carer to the next
• a delay between the injury and presentation
• an injury out of proportion to the alleged accident - for example a fall from a sofa to a carpeted floor being used to explain a skull fracture in a young child.