Introduction

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 …