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Review
. 2024 Mar 30;11(4):413.
doi: 10.3390/children11040413.

Identification and Evaluation of Non-Accidental Trauma in the Pediatric Population: A Clinical Review

Sophia M V Schermerhorn  1 , Oliver J Muensterer  2 , Romeo C Ignacio Jr  3   4
Affiliations
Review

Identification and Evaluation of Non-Accidental Trauma in the Pediatric Population: A Clinical Review

Sophia M V Schermerhorn et al. Children (Basel). .

Abstract

Non-accidental trauma (NAT) is a major cause of morbidity and mortality for children around the world and most significantly impacts children under one year of age. Prompt and comprehensive treatment of these children relies on a high index of suspicion from any medical provider that treats pediatric patients. This review discusses those most at risk for experiencing NAT, and common initial presentations, to assist providers in the identification of potential victims. In addition, this review provides guidance on the recommended workup for these patients so that the full extent of associated injuries may be identified and the appropriate healthcare team may be assembled.

Keywords: child abuse; child physical abuse; non-accidental injury; non-accidental trauma; skeletal survey.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Brief Childhood Abuse Potential Inventory (BCAP).
Figure 2
Figure 2
A skeletal survey of a four-month-old brought in with an inability to move the right arm, allegedly after the older sibling fell on top of him. The skeletal survey showed fresh corner fractures of the humerus and radius on the right (circle highlights) and signs of older fractures on the left (rectangular highlights), a combination that is pathognomonic for NAT.
Figure 3
Figure 3
A two-year-old presented with right mandibular bruising suggestive of NAT (a). Upon physical examination, bruises were also found over the sternum (b) and the genital area (c). The asterisk (*) marks the most prominent bruises.
Figure 4
Figure 4
A nine-month-old was brought in for excessive irritability. Upon physical examination, there were two circular, healing burn marks on the abdomen (a) and back ((b), arrows) later proven to be from cigarette burns. A radiological workup and skeletal survey showed a right femoral fracture (c,d), but no other osseous anomalies.
See this image and copyright information in PMC

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