Definition

Child maltreatment, also referred to as child abuse and neglect, includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual, or potential harm to the childs health, development or dignity.

(WHO)

Subtypes

There are five subtypes that can be distinguished :Physical abuse Sexual abuse Neglect and negligence Emotional abuse Exploitation

Physical Abuse

Physical abuse is the second most frequently reported form of child abuse Can be defined as physical injury inflicted upon the child with cruel and/or malicious intent. Physical abuse can be the result of punching, beating, kicking, biting, burning, shaking, or otherwise harming a child. The parent or caretaker may not have intended to hurt the child, rather the injury may have resulted from over-discipline or physical punishment

Physical Abuse

Physical Abuse

Results in actual or potential physical harm from an interaction or lack of an interaction by the parent or caregiver. May be a single or repeated incident

Physical Abuse - Types

Superficial Injuries

Bruises, Burns

Inflicted Submersion Injuries Fractures and Bony Injuries Intracranial Injuries Abdominal Injuries

Physical Abuse - Signs

Multiple bruises Different Colours ( Fresh bruise = blue or redpurple, Older bruise = yellow, green or brown] Unusual skin damage Burns or Burn Scars Subdural haematoma Bleeding in back of eye Direct Blow to the Head Organ damage

Physical Abuse

Fractured ribs, especially in the back

Evidence of fractures Any fracture in infant too young to walk or crawl

Evidence of skull fracture - multiple and of different ages

Physical Abuse

Physical Abuse
A 5-year-old girl who presented after being slapped on the leg. The markings are bruises and not erythema. The linear parallel lines are virtually diagnostic of a human handprint.

Wrenching or pulling an extremity of an infant may result in a corner chip or bucket handle fracture of the metaphysis
An 8-month-old infant who is brought into the ED by his mother with the history of having fallen from a changing table. Note the acute transverse midshaft humerus fracture. This fracture is most consistent with a snapping injury, not a fall onto a flat surface. The mother subsequently described grabbing the child's arm to lift him after the fall and hearing a snap

Physical Abuse
A 2-month-old infant presented to the ED with the history from the father that the child had slipped in the tub the night before. Note the periosteal callus formation, indicating that the fracture is at least 1 week old and, thus, inconsistent with the history being offered.

Physical Abuse
Tests
Radiology
Skeletal Survey

Chest Radiograph
Abdominal X-Ray

CT Scanning
MRI

Physical Abuse - Tests

Skeletal Survey

Skull - AP and Lateral Chest, Spine and Pelvis - AP Arms and Forearms - AP Hands - PA and Feet - AP Femur and Lower Legs - AP

Lumbar and Cervical Spine - Lateral