Child Abuse Presentation

Question 1

What factors hint at child abuse?

Answer 1

• Story inconsistent with injuries
• Repeated attendances at A&E
• Late presentation
• Child with a frightened, withdrawn appearance - ‘frozen watchfulness’

Question 2

What possible physical presentations might hint at child abuse?

Answer 2

• Bruising
• Fractures: particularly metaphyseal, posterior rib fractures or multiple fractures at different stages of healing
• Torn frenulum: e.g. from forcing a bottle into a child’s mouth
• Burns or scalds
• Failure to thrive
• Sexually transmitted infections e.g.Chlamydia, Gonorrhoea, Trichomonas