Evaluation of physical abuse in children

Family physicians who are involved in the care of children are likely to encounter child abuse and should be able to recognize its common presentations. A history that is inconsistent with the patient's injuries is the hallmark of physical abuse. A pattern of physical findings, including bruises and fractures in areas unlikely to be accidentally injured, patterned bruises from objects, and circumferential burns or bruises in children not yet mobile, should be viewed as suspicious for child abuse. Family physicians who suspect physical abuse are mandated to make a report to the state child protective services agency and to assure the ongoing safety of the child.