chapter  6
38 Pages

Supporting Evidence in Physical Child Abuse

ByKAREN J. GRIEST

Many of the more subtle forms of child abuse leading to death are associated with, and diagnosed due to, classical child abuse injuries, i.e., bruises, fractures, etc. (Table 6.1).1,2

6.2.1 Denitions and Differential Diagnosis

Cutaneous injuries are the most recognizable and common form of physical abuse. A bruise, or ecchymosis, or a contusion, is usually the result of blunt trauma or a squeezing that crushes the tissues and ruptures blood vessels but does not break the skin. Abrasion is scraping and removal of the superficial layers of the skin, usually limited to the epidermis, and usually caused by a tangential frictional force. Scratches are narrow and linear abrasions caused by a sharp edge, fingernail, or claw.3