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Evaluating a bruise of possible abusive aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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:

  • 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:

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