Atlas of Child physical abuse, CLINICAL ATLAS, PEDIATRIC ATLAS, PHYSICAL AND SEXUAL ABUSE, ATLAS IN MEDICAL,
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| FIGURE 1. Bruising to the left buttock noted in a 1-month-old child. Any bruising on an immobile child is highly concerning for child physical abuse. Bleeding disorders must be considered in the differential diagnosis. |
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| FIGURE 2. Healing eighth posterior rib fracture in the same child from Figure 1. A skeletal survey is indicated in any child younger than 2 years of age where suspicions of physical abuse exist. |
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| FIGURE 3. A 15-month-old boy who has been physically abused by his mother’s boyfriend for several weeks. There is bruising under both eyes, with the greatest degree of bruising seen under the right eye and on the right cheek. The boy is in the emergency department after concerned relatives called the police. |
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| FIGURE 4. Same 15-month-old boy from Figure 3 with multiple ngernail gouges in his right axilla. Some are fresh and one appears to be older and somewhat crusted. Injuries in different stages of healing may indicate chronicity of abuse. |
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| FIGURE 5. Same boy from Figure 3 with oblique x-ray showing healing rib fractures with callus in eight different locations as marked by the arrows. The degree of callus formation shows that these rib fractures are not new. Oblique radiographs should be requested in addition to a “skeletal survey” because lateral rib fractures are best seen with this view. |
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| FIGURE 6. Linear ecchymosis on the cheek of a baby who was slapped in the face by an abusive parent. |
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| FIGURE 7. Toddler being seen for a burn caused by hair straightener. The family claimed the iron fell onto the leg but further investigation seemed to indicate that the iron was applied to the child by an angry parent to control a crying child. Although the iron falling could explain the injury on the calf, it does not explain the additional injury higher up on the leg. |
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| FIGURE 8. Bruising of the ear in a young boy who was physically abused by a parent. Ear bruising is rarely accidental. The additional bruising on the cheek suggests this child was hit with a hand or another object to produce the bruising seen in this photo. |
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| FIGURE 9. Young girl with linear bruising on the back, buttocks, and thigh from being hit with a belt. One bruise appears to have a loop-like form (arrow) and was likely caused by blows with a cord or a looped belt. Blows with exible objects produce patterns that tend to conform to the curved surfaces of the body, whereas in exible objects may produce a discontinuous pattern over curved surfaces. |
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| FIGURE 10. Young girl with severe subgaleal hematoma with extensive blood tracking into the upper face after being lifted off the ground by her hair. Blood tracking after signi cant injury is most commonly seen on the face, although some injuries to the genitals may also track into the perineum. |
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| FIGURE 11. Young boy with the marks of coining on his back. A coin was rubbed across his back leaving ecchymoses over bony prominences with the intent to help the child heal from an acute illness. This cultural practice is more common among Asian immigrants to this country and mimics child abuse. |
This is only a part of the book : Color Atlas of Pediatrics 1st Edition of authors: Richard P. Usatine, MD; Camille Sabella, MD; Mindy Ann Smith, MD; E.J. Mayeaux, Jr., MD; Heidi S. Chumley, MD and Elumalai Appachi, MD, MRCP (UK). If you want to view the full content of the book and support author. Please buy it here: https://goo.gl/BEp0yD
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