IDENTIFICATION & PREVENTION: A LITERATURE REVIEW INVESTIGATING THE CLINICAL MANIFESTATIONS OF PHYSICAL CHILD ABUSE IN THE OUTPATIENT SETTING
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Date
2021-05-15
Authors
Page, Shelby
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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.
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Keywords
PHYSICAL CHILD ABUSE, OUTPATIENT SETTING, CLINICAL MANIFESTATIONS, child abuse