⚠️ Child Abuse · Recognition & Mandatory Reporting Tool

Schwartz Clinical Handbook — Chapter 20 · Physical abuse · Bruising patterns · Fractures · Burns · Abusive head trauma · Retinal hemorrhages · Munchausen by proxy

Select injury patterns, bruising locations, fracture types, head/oral findings, and history discrepancies to assess likelihood of physical abuse and guide mandatory reporting.
⚠️ Mandatory reporting: Any reasonable suspicion of abuse must be reported to Child Protective Services / law enforcement.

📋 Step 1 — Injury patterns & concerning findings
📌 Assessment & required actions
📖 Schwartz Ch 20

Select bruising pattern (locations, stages), fracture types (rib, metaphyseal, complex skull), oral injuries, burns, head trauma signs, and history inconsistencies → system estimates abuse likelihood and outlines mandatory reporting, skeletal survey, and referrals.

✔️ Bruising in non‑mobile infant → highly suspicious.
✔️ Posterior rib fractures → pathognomonic for abuse.
✔️ Retinal hemorrhages + subdural → shaken baby.
✔️ Unexplained delay in seeking care → red flag.
📘 Schwartz pearls (Chapter 20)
• Skeletal survey mandatory in all children <2 years with suspected physical abuse.
• Retinal exam by ophthalmologist for intracranial injury.
• Differentiate from osteogenesis imperfecta, bleeding disorders, accidental trauma.
• Report — do not investigate; protect child from further harm.