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Bruising is common among children, arising from both accidental and non-accidental injury (NAI).1 Discriminating between abusive and accidental bruises poses a diagnostic challenge. Accidental patterns of childhood bruising2 and those suggestive of NAI are different, with bruises to the ears, cheeks and mouth in the non-mobile infant3 being more concerning. By contrast, accidental bruises on the legs and shins are common in mobile children.2 Children at high risk for further serious abusive injury can present initially with minor bruising. They need to be identified and protected.
The paediatricians’ role is to assess the history and presentation of bruising to determine its cause. Regular child protection training remains a core competency for all …
Contributors CWC: undertook the study and recruited participants, analysed the data and drafted the article. AM: advised on the design of the study materials and gave editorial advice on the article. DT: advised on the study design, supplied the images used and gave editorial advice on the article.
Competing interests None declared.
Ethics approval Registered with the quality improvement department.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All study data and analysis are included in the article. All data records are kept by CWC.
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