Presentation of child abuse

Children may disclose abuse themselves. Other factors which point towards child abuse include:

• Story inconsistent with injuries
• Repeated attendances at A&E departments
• Delayed presentation
• Child with a frightened, withdrawn appearance - 'frozen watchfulness'

Possible physical presentations of child abuse include:

• Bruising
• Fractures: particularly metaphyseal, posterior rib fractures or multiple fractures at different stages of healing
• Torn frenulum: e.g. from forcing a bottle into a child's mouth
• Burns or scalds
• Failure to thrive
• Sexually transmitted infections e.g. Chlamydia, Gonorrhoea, Trichomonas

NICE guidelines

Neglect

Sexual abuse

Physical abuse