Determining Bruise Etiology in Muscle Tissue Using Finite Element Analysis

Tang, Kevin; Sharpe, Wyatt; Schulz, Alexandra; Tam, Edric; Grosse, Ian R.; Tis, John E.; Cullinane, Dennis M.

doi:10.1111/1556-4029.12349

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Jackson et al [14] highlight the contribution to delay in abuse diagnoses via clinical inattention to soft tissue findings. Accordingly, soft tissue bruising, for example, the result capillary failure via blunt trauma [15][16][17], in any of the locations indicated by the Frequency or Specificity (Tables 2 and 3) should also be considered a significant finding.…”

Section: Discussionmentioning

confidence: 99%

The Symptoms of Child Physical Abuse by Frequency and Specificity

Lee¹,

Noh²,

Barber³

et al. 2017

Forensic Biomechanics

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IntroductionFor children in the United States between the ages of one and four, the three leading causes of death in 2014 in descending order were unintentional injuries, congenital anomalies, and homicide. Similarly, homicide was the number two causes of death for children less than one year old [1]. Clearly, child abuse is perennially a leading cause of morbidity and mortality in young children and infants [2], with more than four children dying in the United States every day as a consequence [3]. Aside from physical trauma, child abuse also results in significant psychological and sociological impacts [4], as well as personal and civic costs [5]. The authors estimated the lifetime cost per victim of nonfatal child maltreatment was $210,012 (2010 dollars), with a total lifetime economic burden resulting from all new cases of fatal and nonfatal child maltreatment at approximately $124 billion. Clearly, child abuse is a significant social dilemma, and it is manifested in different forms, including neglect, sexual, emotional, and physical, and yet its clinical recognition is relatively recent. Caffey's study garnered a great deal of attention in the medical community because of its revolutionary effort to recognize how patterns of injury, medical history, and parent behavior are indicative of child abuse. In doing so, he was the first to question the sanctity of the parent-child relationship. He was also the first to identify an abuse constellation: long bone fracture and subdural hematoma. A constellation arises when two or more symptoms of abuse are manifested in a potential victim and whose collective suspicion index rises above the sum of the individual symptoms. In this way, Caffey presciently defined the landscape for all future abuse studies. Despite Caffey's findings, the prevalence of child abuse was not widely acknowledged by the general population until Kempe et al. [6] published their research on the battered-child syndrome, inciting the first national movement towards addressing child abuse. This movement culminated in the passage of the 1974 Child Abuse Prevention and Treatment Act. Despite these advances, it was estimated that 1,580 children in the United States died from physical abuse in 2014 [3], and failure to recognize child maltreatment results in chronic exposure to high-risk environments where re-injury or death may occur, with AbstractThe modern medical history of child physical abuse dates back to 1946 with the publication by John Caffey, Multiple Fractures in the Long Bones of Infants Suffering from Chronic Subdural Hematoma. This now-classic paper was the first modern clinical recognition of child physical abuse and laid the cornerstone for all future clinical diagnoses, as well as prevention and prosecution legislation at state and federal levels. Today, the primary literature is replete with descriptions and analyses of the symptoms of child abuse, but the typical focus is on individual symptoms, their frequencies, and how to diagnose them. Despite the obvious clinical and legal adva...

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