The term medical child abuse (MCA) focuses on potential or real harm to a child, regardless of the caretaker’s motivations. MCA is the preferred term for the spectrum of caretaker be...
Symptoms and signs described are incongruous with patient’s appearance or are seen only when the caregiver is present.
Diagnostic tests fail to confirm th...
Mild:
Recommended consultation with a child abuse specialist to help differentiate from a case of simply an anxious parent. The physician should avoid giving in to irrational demands for test...
Psychological treatment for caretaker and child if appropriate
Long-term follow-up is necessary for both victim and caregiver.
Watch for recurrence of original pres...
Bass C, Glaser D. Early recognition and management of fabricated or induced illness in children. Lancet. 2014;383(9926):1412–1421. [View Abstract on OvidInsights]
Brown P, Tier...
F68.12 Factitious disorder w predom physical signs and symptoms
F68.13 Factitious disord w comb psych and physcl signs and sympto...
Q: When should MCA be reported to child abuse authorities?
A: When there is reasonable suspicion (note: not certainty) that a child is coming to harm due to the actions of a caregiver. When suspici...
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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 heali...
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 inj...