Childhood bruising distribution observed from eight mechanisms of unintentional injury

Abstract

These findings have the potential to aid an assessment of the plausibility of the explanation given for a child with bruising. Certain bruise distributions were rarely observed, namely multiple bruises from a single mechanism, petechiae and bruising to the ears, neck or genitalia.

Unilateral anoxic brain injury secondary to strangulation identified on conventional and arterial spin-labeled perfusion imaging

“…Bruises to ears, neck, or genitalia are rarely associated with accidental mechanisms of injury in infants and children. Neck and facial petechiae and bruises involving mandible, submental space, and neck warrant further evaluation for strangulation or other asphyxiation [4] , [5] .…”

Bruising characteristics from unintentional injuries in children: the ‘green flag’ study

“…This study on bruising from eight specific unintentional injuries provides several take away points 6. Among the 372 children examined who had bruising, all but seven of these children were mobile, no one had more than five bruises from a single incident and the majority had only one bruise.…”

“…In the linked article titled ‘Childhood bruising distribution observed from eight mechanisms of unintentional injury’, authors Hibberd and colleagues6 provide new, detailed evidence of bruising characteristics in context to the child’s age and developmental capabilities. They analysed injuries resulting from eight recognised trauma mechanisms adapted from the International Classification of External Causes of Injury.…”

“…Table 2 highlights key ‘green flags’ of bruising characteristics to aid with assessing injury plausibility as identified in the study by Hibberd et al 6 Table 3. highlights potential red flags of abuse and reports on the low or no occurrences in this study of bruising from unintentional injury.…”

“…In summary, the study by Hibberd et al provides a new level of evidence and improved accuracy for assessing injury plausibility and bruising 6. Key identified factors in relation to the stated cause of injury includes the age of the child and developmental stage, the number of bruises and location of bruises on the body and whether the bruise is patterned or petechial.…”