Child Abuse Flashcards
Types of physical child abuse
Drowing
Hair pulling
Blows or Strikes
Twists or pulls (causing fractures)
Forced restraint
Forced ingestion
Burns or scalds
Strangulation
Other terms for child abuse
• Shaken baby syndrome (now it’s called shaken impact syndrome)
• Non Accidental Trauma (NAT)
• Child battering
Parental factors correlated with being abuser:
Teenage parent
Single or divorced parent
Drug or alcohol abuser
Crowded house
Low socioeconomic status
Emotionally immature
Himself abused as a child
Children prone to being abused
Less than 6 years
Unwanted pregnancy
Twins
Chronically or reccurently ill
Physically or mentally handicapped
Features of medical history, which may indicate child abuse:
• History not consistent with type or severity of injury
• child is afair of caretaker
• caretaker doesn’t know the etiology of the injury
• different history bt the caretaker and the child
Physical exam findings indicative of possible child abuse:
• Multiple injuries of various ages
•sharply demarcated burns (scalds)
• retinal hemorrhage (SBS)
• bizarre injuries (cigarettes burns, bite, or belt marks)
• perioral, perineal, anal, or genital injuries
X-ray findings indicative of possible child abuse:
Spiral fracture of long bone (twists)
Multiple rib fracture
Femur fracture
Multiple fractures in different stages of healing
Skin conditions that may mimic signs of child abuse:
• Mangolian spots
• Other “birthmark” like hemangioma
• Folk treatments (cupping or coning)
Thrombocytopenia or congenital coagulation disorders
Alopecia areata or tinea infection
Medical conditions that can mimic skeletal findings of child abuse:
Osteogenesis imperfecta
Rickets
Scurvy
Metastatic bone tumours
Meningomyelocele
Congenital syphilis
Homocystinuria
Prostaglandin therapy
Hypophosphatasia
Leading cause of fatal child abuse
Head trauma
Most common skeletal injury with child abuse:
ribs and long bone fractures (in lecturer words)
Type of intracranial hemorrhage in child abuse:
Subdural hemorrhage
Second most common skeletal injury with chid abuse:
Skull fractures
how much percent of abused children show signs of head trauma?
10%
Suspect child abuse if skull fracutre:
Complex (multiple or “eggshell”, displaced, diastatic, comminuted, or cross suture line)
Percent of retinal hemorrhage in shaken impact syndrome:
80%
Can lead to blindness
Percent of retinal hemorrhage in accidental head trauma cases:
3%
Shaken baby syndrome may presetn with:
Coma or seizures without evidence of scalp trauma
We suggest renaming “shaken baby syndrome” to “shaken impact syndrome”
Recent studies indicate that most cases are not caused by shaking alone but by thrown the impact of head against wall or object
First cause of death in child abuse
Head injury
Second cause of death in child abuse:
Abdominal trauma:
May have organ perforation, obstruction, laceration and rupture
Perineal or genital injuries may not always represent sexual abuse:
May be punishment for toilet training accidents
“All of them are child abuse”
