Accident or abuse? Differential diagnosis of contact burns from radiators/heaters in children

Abstract

Contact burns in children are not uncommon and are often due to accidental contact. Medico-legal assessment is of paramount importance in these contexts to identify cases of abuse. In three cases of burns caused by contact with radiators or a portable heater -two accidental and one deliberate- thorough medico-legal assessment, combined with on-site event reconstruction, enabled accurate diagnoses. Accidental burns displayed a ‘pattern’ compatible with the incandescent instrument but were more irregular, with different depths and in different parts of the body. In contrast, intentional burns were uniform in depth, distribution and localisation, inconsistent with accidental events. In this context, the on-site inspection and direct evaluation of the objects involved were crucial in the medico-legal assessment. These are indispensable elements for a thorough analysis and abuse recognition.