Skip to main content
General Medicine

Child Abuse

Ashley Nicole Koontz, DO and Jason R. Croad, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Types of abuse: neglect (most common and highest mortality), physical abuse, emotional/psychological abuse, sexual abuse

  • Neglect includes physical (e.g., failure to provide necessary ...

DIAGNOSIS

  • Relatively minor injuries, frenulum tears, or bruising in precruising infants may be the first indications of child physical abuse; these minor, suspicious injuries have been termed “sentine...

TREATMENT

GENERAL MEASURES

If HIV exposure possible, consider prophylaxis. 

MEDICATION

First Line

Antibiotics as indicated for STIs 
ALERT

Emergency contraception reduces rate of pregnancy after sexual assa...

ONGOING CARE

PROGNOSIS

Without intervention, child abuse is often a chronic and escalating phenomenon. 

COMPLICATIONS

Sexual, physical, and emotional abuse in childhood are risk factors for poorer adult ...

REFERENCES

1
U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2019). Child maltreatment 2017...

CODES

ICD10

  • T74.12XA Child physical abuse, confirmed, initial encounter

  • T74.32XA Child psychological abuse, confirmed, initial encounter

  • T74.22XA Child sexual abuse, confirmed, initial encounter

  • T74.92XA ...

CLINICAL PEARLS

  • When a bruise is present, it should be considered as potentially sentinel for physical abuse if no plausible explanation is given.

  • High index of suspicion is important for prevention an...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

START 10-DAY FREE TRIAL
Subscribe Now
GET CME/CE
Related Images
Left Arrow Button Right Arrow Button
FIG. 26.6. Radiographic findings of child abuse. A: Multiple skull fractures in an infant. B: Left humeral fracture and multiple old healing rib fractures. C: Left femoral fracture and metaphyseal chip avulsion fractures of the right distal femur. D: Healing fracture of the right femur with callus formation and new periosteal bone formation. E: "Bucket-handle" deformity of healing distal tibial epiphyseal fracture. F: Bone scan shows multiple areas of increased uptake caused by trauma. Some...
FIG. 26.6. Radiographic findings of child abuse. A: Multiple skull fractures in an infant. B: Left humeral fracture and multiple old healin...
FIG. 26.6. Radiographic findings of child abuse. A: Multiple skull fractures in an infant. B: Left humeral fracture and multiple old healing rib fractures. C: Left femoral fracture and metaphyseal chip avulsion fractures of the right distal femur. D: Healing fracture of the right femur with callus formation and new periosteal bone formation. E: "Bucket-handle" deformity of healing distal tibial epiphyseal fracture. F: Bone scan shows multiple areas of increased uptake caused by trauma. Some...
FIG. 26.6. Radiographic findings of child abuse. A: Multiple skull fractures in an infant. B: Left humeral fracture and multiple old healin...
FIG. 26.11. Shaking injuries. A: Small bruise of right cheek (arrow) in a 6-month-old shaking victim was the only external evidence of injury. The photograph was taken shortly after admission to the hospital to document that the injury was not iatrogenic. The child died the following day and at autopsy had typical findings of shaken baby syndrome. Manifestation of whiplash shaking injury. (From Reece RM, Ludwig S. Child abuse: medical diagnosis and management, 2nd ed. Philadelphia: Lippinco...
FIG. 26.11. Shaking injuries. A: Small bruise of right cheek (arrow) in a 6-month-old shaking victim was the only external evidence of inju...
FIG. 26.3. Immersion burns. A: Hot water burn in an immersion pattern. B: Hot liquid spill burns sustained by a 6-month-old child.
FIG. 26.3. Immersion burns. A: Hot water burn in an immersion pattern. B: Hot liquid spill burns sustained by a 6-month-old child.
Hemorrhages involving all layers of retina and the choroid. Hemorrhage in vitreous superotemporal to disc is breakthrough from the dome-shaped prehyaloid hemorrhage in macular area. Note disc edema, venous stasis.
Hemorrhages involving all layers of retina and the choroid. Hemorrhage in vitreous superotemporal to disc is breakthrough from the dome-sha...
    ×
     
    ©2020 Wolters Kluwer Health, Inc. and/or its affiliates. All rights reserved.

    Enter An Access Code

     
    We are unable to redeem your access code. Please try again another time.
    Enter the code from your copy of The 5-Minute Clinical Consult or another access code to create an account.
    ×
    ×
    This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept