IDENTIFICATION & PREVENTION: A LITERATURE REVIEW INVESTIGATING THE CLINICAL MANIFESTATIONS OF PHYSICAL CHILD ABUSE IN THE OUTPATIENT SETTING

Abstract

Objective: Characteristics and patterns of abusive injuries in children are controversial and not uniformly recognized across all healthcare providers (HCPs). The purpose of this study was to identify the most common clinical manifestations of physical abuse in children < 24 months old and provide a concise resource to help improve the identification and prevention of physical abuse in this age group. Methods: A literature search using PubMed database was performed using key terms pertaining to “characteristics of abusive injuries,” “red flags of child abuse,” “clinical signs of child abuse,” and “sentinel injuries.” Eight articles were found to meet this inclusion criterion and were analyzed in this review. Results: This review identified that bruising, burns, oral injuries and fractures are the most common clinical manifestations of physical abuse in children < 24 months old. Specific characteristics of these injury types can distinguish between accidental and non-accidental circumstances. These characteristics include bruising location and pattern, type and location of burns, oral injuries and fractures’ number and location. Conclusions: The specific patterns and characteristics of abusive injuries described in this review can aid in evaluating pediatric patients < 24 months old. This review aims to encourage the application of identification and prevention of physical child abuse into daily practice by improving the recognition of abusive injuries across all healthcare settings. All HCPs should maintain a low threshold to evaluate for abuse and report potential abuse at the first contact when clinical suspicion is present.