Bruising in abused children Do all abused children have bruising?
Bruising is the commonest manifestation of child abuse. It is evident in up to 98% of abused infants under nine months of age. However, even in fatally abused infants, bruising may not always be present. The absence of bruising cannot exclude serious injury. Which areas are most commonly bruised in abuse? Of the fatally abused children under five years of age, the commonest site of bruising was the face. 78% of abused children less than four years had facial bruising, in comparison to non-abused children of this age group where 2% had facial bruising. In abused children, bruising is also much more common on the ear, head and neck, chest, abdomen, back and buttocks. Bruising to the hand occurs in up to one third of abused children. Are there patterns of bruising that indicate abuse? A recognised feature in abused children is clustering of bruises. These clusters of bruises are often defensive injuries: on the upper arm, outside of thigh. Are there patterns that indicate particular cause
