Inadequately Explained Injury (Child Abuse)
Key Conditions
Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.
Clinical Approach
Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.
Vignette
An 8 month male is brought to the emergency department due to fussiness. It was found in the emergency department that he has a femur fracture, and on examination had multiple visible bruises on his torso
Diagrams
No diagrams added.
Pre-Clerkship
Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.
Lectures
- Non-Accidental Trauma - Multidisciplinary Approach Course 6
- Non-Accidental Trauma 1 Course 6
- Non-Accidental Trauma 2 Course 6
- Domestic Violence and Sexual Assault Course 6
- Non-Accidental Trauma (C2) Course 2
- Family Violence Course 7
Small Groups
Clerkship
Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.
Objectives
By the end of the Paediatric Clerkship, a medical student will be able to:
- Define the different types of child maltreatment.
- List the risk factors for child maltreatment.
- List the ͞red flags͟ of a history and physical examination that raise the suspicion of child maltreatment.
- Recognize normal and abnormal patterns of injury in children.
- List the appropriate people to be contacted if child abuse is suspected.
Half Day Cases
- A 6 month old infant was brought into the Emergency Department with a femur fracture
- A 5 year old child comes into your clinic due to a fever. You notice when you examine him that he does not make eye contact, and is very hesitant to be examined. You notice that he has bruises on his back
Resources
The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.
Papers
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Which injuries may indicate child abuse? .
95: 170-177
Arch Dis Child Educ Pract Ed (2010) Overview article in BMJ. -
The medical assessment of bruising in suspected child maltreatment cases: A clinical perspective.
https://www.cps.ca/en/documents/position/medical-assessment-of-bruising
Canadian Pediatric Society statement (2013)
Cards
No cards.
Videos
No videos.