All paediatricians, paediatric radiologists, paediatric pathologists, forensic pathologists, and many other specialists have to deal with cases of suspected child abuse, and in terms of the generation of complaints from families this is a high risk activity. Many complaints are devoid of merit, but in some cases a complaint is justified because of a faulty approach. This review draws attention to the avoidable pitfalls associated with report writing when child abuse is under consideration (see box 1).

The modern guidance on the duties of experts in cases of suspected child abuse stems in part from a care proceedings case heard in 1990. A 3 month old baby was admitted to hospital with serious injuries comprising subdural haemorrhages of more than one age, damage to the brain, multiple rib fractures, and multiple limb fractures. Despite the evidence pointing to child abuse, a number of experts from various disciplines offered a variety of unjustified or highly improbable alternative medical explanations (including abnormally fragile bones) for the injuries. The judge was highly critical of some of the expert reports and evidence given in court, and in his published judgment he gave clear advice concerning the duties of an …