Child Abuse: Clinical Findings and Management

2000 ◽  
Vol 12 (11) ◽  
pp. 467-471 ◽  
Author(s):  
Susan E. Chaney
2019 ◽  
Vol 39 (01) ◽  
pp. 028-035
Author(s):  
Werner Streif ◽  
Irmina Watzer-Herberth ◽  
Gabriele Hahn ◽  
Uwe Schmidt ◽  
Ralf Knöfler

AbstractChildren with an unexplained bleeding tendency are frequently referred to a haemostaseologist for further evaluation. Careful standardized history taking and clinical evaluation should allow for distinguishing bleeds after minor injury and trauma which are very common in all children. However, in two groups of children bleeding symptoms may be more significant than expected: those with an underlying coagulation disorder and those who have been subjected to physical child abuse. The coexistence of child abuse and a bleeding disorder must always be considered. An extended coagulation diagnostic is required if the morphology of bleedings is not clearly suspicious for child abuse and in the absence of typical concomitant injuries, e.g., bone fractures. An interdisciplinary approach involving a forensic pathologist and a paediatric haemostaseologist for assessment of bleeding symptoms, the explanation of the clinical findings, and the critical evaluation of laboratory results are essential in such cases. This review is focussed on symptoms in accidental and nonaccidental injuries in children assisting haemostaseologists in decision making in cases of child protection issues.


Author(s):  
Mustafa Hussein Ajlan Al-Jarshawi ◽  
Ahmed Al-Imam

Background Medical child abuse describes a child receiving unnecessary, harmful, or potentially harmful medical care at the caretaker's instigation. Objectives To focus on medical child abuse as an entity and emphasize its epidemiology, clinical presentations, prevention, and management. Results In the UK, the annual incidence of medical child abuse in children below one year increased to 3:100,000, while its prevalence in Arabs, including Iraq, is ambiguous due to lack of evidence and improper clinician's awareness. The mean age at diagnosis is 14 months to 2.7 years. Female caregivers are the most common offenders. Clinically, medical child abuse could fit into three stages; falsification of illness story, falsification of illness story and physical signs' fabrication, or induction of illness in children. A successful diagnosis mandates a comprehensive review of medical records to identify discrepancies between caregivers' stories versus clinical findings or investigations. Management requires recognizing abuse, halting it, securing the child's safety, maintaining the family's integrity when possible, and aborting unnecessary lateral referrals within the healthcare system. Conclusion Reported cases of medical child abuse are increasing steadily, while less severe ones go unrecognized. No diagnostic tool can help other than the physician's high index of suspicion. The management follows the same principles applied for other forms of child abuse, while good medical practice ensures its prevention.


PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 642-643
Author(s):  
Arthur C. Jaffe ◽  
Daniel H. Lasser

Ever since Caffey's classic description of its clinical findings,1 physicians have been aware of the syndrome of child abuse and its skeletal pathology. Because of the emphasis placed on them by Caffey1 and others,2,3 it is now considered standard medical practice to obtain roentgenograms of the skull, ribs, and long bones as part of the routine evaluation of suspected child abuse. We are reporting an abused infant with multiple metatarsal fractures, an apparently undescribed finding in maltreatment syndromes. We also raise the question of whether or not roentgenographic search for fractures of the small bones of the extremities should be routinely performed.


1965 ◽  
Vol 30 (4) ◽  
pp. 325-335
Author(s):  
George E. Lynn ◽  
Jack A. Willeford
Keyword(s):  

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.


1974 ◽  
Vol 110 (3) ◽  
pp. 382-388 ◽  
Author(s):  
H. M. Doeglas

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