Pediatric Abuse

Question 1

What are the two most common causes of death of children?

Answer 1

1) Accidental

2) Child abuse

Question 2

What are social risk factors for child abuse?

Answer 2

1) recent job loss of parent
2) children with disabilities (cerebral palsy, premature)
3) step children

Question 3

What type of fracture is most common presentation of child abuse?

Answer 3

Simple transverse long bone

humerus > tibia > femur

Question 4

What fracture patterns are suspicious for child abuse?

Answer 4

1) metaphyseal corner fractures
2) spiral fractures
3) multiple fractures at different stages of healing
4) single transverse long bone fractures
5) posterior rib fractures
6) skull fractures

Question 5

What is the most common presenting sign of child abuse?

Answer 5

skin cuts or bruises; fracture are second most common

Question 6

What area of the bone do metaphyseal corner fractures occur?

Answer 6

Primary spongiosa

Question 7

What is the physicians role in suspected child abuse?

Answer 7

1) Physicians are mandated reporters, and are legally obligated to report suspected child abuse and neglect.
2) Physicians are granted immunity from civil and criminal liability if they report in good faith, but may be charged with a crime for failure to report
3) early involvement of social workers and pediatricians is essential

Question 8

What % of non-accidental trauma (abuse) occurs in children under age of 4?

Answer 8

79%

Question 9

A distal humerus physeal separation is suspicious for what condition?

Answer 9

Child abuse

Question 10

What are the two most common lesions seen in abused children?

Answer 10

Skin lesions and fractures