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Estimation of the age of bruising
1Department of Child Health, University Hospital, Nottingham.
Insights
Determining a bruise's age in children from its color is unreliable. This study found bruise aging from photographs is less precise than forensic textbooks suggest, impacting child abuse investigations.
Area of Science:
- Forensic Medicine
- Paediatric Medicine
- Dermatology
Background:
- Paediatricians frequently assess non-accidental bruises in children.
- Current forensic textbook information on bruise aging lacks specific research in pediatric populations.
- Accurate bruise age estimation is critical in non-accidental injury evaluations.
Purpose of the Study:
- To document the color changes of accidental bruises in children over time.
- To provide a research-based understanding of bruise color progression in pediatric cases.
- To evaluate the accuracy of bruise aging based on photographic evidence.
Main Methods:
- Photographic documentation of 50 accidental bruises in 23 children with known injury ages.
- Standardized photographic procedures using consistent equipment by a medical photographer.
- Blind review of bruise photographs by a single observer to describe color characteristics.
Main Results:
- Red coloration was observed in 15 of 37 bruises under one week old.
- Yellow coloration was present in 10 of 42 bruises older than one day.
- Photographic assessment for bruise age determination proved significantly less precise than commonly implied.
Conclusions:
- The color changes of bruises in children are not as predictable as suggested by current forensic literature.
- Photographic aging of pediatric bruises is less reliable than often assumed.
- Further research is needed to establish accurate methods for dating bruises in children.
Abstract:
Paediatricians are often requested to give an opinion on the age of a non-accidental bruise. In forensic textbooks, the colour changes which a bruise undergoes with time are not based on research in children. The purpose of this study was to document the sequence of colour changes in photographs taken following accidental bruising in children. Fifty accidental bruises of known age in 23 children were photographed by a medical photographer using the same equipment throughout. The photographs were reviewed by a single observer, blind to the true age of the injury, who described the colours present in the bruise. Red colouration was seen in 15 out of 37 bruises which were less than one week old. Yellow colouration was seen in 10 out of 42 bruises over one day old. Aging of bruises from photographs was much less precise than textbooks imply.