Which clinical history findings are characteristic of physical child abuse?

Updated: Apr 24, 2017
  • Author: Angelo P Giardino, MD, MPH, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

The past medical history should be explored for general health and previous trauma and hospitalizations, as well as for the source of healthcare and developmental and social aspects of the child's life. In cases of maltreatment, the history is often inaccurate and misleading. The following historical elements should raise concerns for possible physical abuse:

  • Details change, or additional scenarios are suggested, as additional trauma is identified or as the cause of the trauma is questioned

  • Details are inconsistent among caregivers

  • Caregivers give implausible details not congruent with the trauma observed on examination

  • Caregivers describe minor trauma, but the child displays major injury on examination

  • No history of trauma is offered

  • Injury described as self-inflicted is not possible given the age/developmental abilities of the child

  • Caregivers demonstrate a significant delay in seeking treatment for the child

  • Serious injury is blamed on a younger sibling/playmate

  • Caregiver frequently changes healthcare facilities, pediatricians, or emergency departments


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