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Published on: April 7, 2023
Fifteen-minute consultation: Bruising in the premobile child
Fiona Wallace1, Julie-Ann Collins1, Nishanthi Talawila Da Camara2
1Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, Belfast, UK.
Insights
Bruising in infants who cannot yet walk is rare and may suggest physical abuse. This article guides clinicians on assessing infant bruises, considering other causes, and ordering necessary tests.
Area of Science:
- Pediatrics
- Child Abuse
- Medical Diagnostics
Background:
- Bruising in premobile infants is uncommon.
- It raises concerns for physical abuse in this vulnerable population.
- Clinical assessment is crucial.
Purpose of the Study:
- To outline an approach to evaluating bruises in premobile infants.
- To discuss differential diagnoses for infant bruising.
- To review the evidence base for assessment and investigation.
Main Methods:
- Case vignette presentation.
- Discussion of clinical assessment strategies.
- Review of relevant medical literature and evidence.
Main Results:
- A systematic approach is necessary for evaluating infant bruises.
- Differential diagnoses must be considered.
- Multidisciplinary team involvement is recommended.
Conclusions:
- Thorough assessment and appropriate investigations are key.
- Understanding potential causes beyond abuse is vital.
- Evidence-based practice guides clinical decision-making.
Abstract:
A bruise in a premobile infant is an uncommon finding and often results in referral to the paediatric or emergency departments, acknowledging the potential for physical abuse in this vulnerable cohort. Our role as clinicians is to undertake a thorough assessment, consider potential differentials and organise appropriate investigations, with involvement of the wider multidisciplinary team. In this article, we use a case vignette to discuss how one would approach a bruise in the premobile infant including the evidence base.
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