Dating of Bruises in Children: An Assessment of Physician Accuracy

Abstract

Physician estimates of bruise age are highly inaccurate within 24 hours of the actual age of the injury. Large individual variability and poor interrater reliability also suggest that caution must be used when interpreting these estimates. This study supports earlier studies, urging extreme caution in estimating bruise age, even when such estimates are based on direct examination of the injured area.

Origin and assessment of bruises in beef cattle at slaughter

“…The latter accounts for the numerous studies carried out in recent decades with the aim of developing a method for ageing bruises in human skin (Langlois and Gresham, 1991;Betz, 1994;Sawaguchi et al, 2000;Bariciak et al, 2003;Bonelli et al, 2003;Hughes et al, 2004 andRandeberg et al, 2006;Grellner and Madea, 2007;Kondo, 2007).…”

“…A bruise -defined as a tissue injury with rupture of the vascular supply and accumulation of blood and serum (Hoffman et al, 1998) -develops after the application of force, usually by a blunt object, sufficient to disrupt blood vessels (Bariciak et al, 2003). As soon as tissue is damaged, a region of localized hypersensitivity occurs around the injury area.…”

Hangi Bulgular Fiziksel İstismarı Düşündürür?

“…Ekimozun yerine, dokulardaki kanama miktarına, kan dolaşımına bağlı olarak renk değişikliği günler sonra ortaya çıkabilir bazen de aynı ekimozun içinde farklı renkler olabilir. Bu nedenlerle ekimozun rengine göre olay zamanı belirlemek mümkün olmayabilir (15).…”

Can color inhomogeneity of bruises be used to establish their age?

“…Even the use of reflectance spectroscopy to give improved color assessment [7][8] cannot make the determination of age more accurate, as color progression depends on the size, shape, depth and body location of the bruise, as well as on the person's age, skin thickness and skin type [2,[9][10][11][12]]. …”