Suspected Non-Accidental Injury (Child Abuse) in Paediatrics



Non-accidental injury in children, commonly known as child abuse, is a serious issue that requires immediate attention and intervention. Medical professionals should be vigilant in recognizing the signs and symptoms that may indicate abuse.

Clinical Presentation

1. Delayed presentation to medical care

2. Delay in attaining developmental milestones, e.g., low weight for age.

3. Discrepancy between caregiver’s explanation for injury and actual clinical findings

4. Multiple or recurrent injuries

5. Bruises or injuries in areas not commonly exposed to accidental trauma.

6. Bruises of varying ages and colours

7. Behavioural signs such as extreme irritability, excessive crying, or a child avoiding eye contact.

8. A child living with a friend.

Risk Factors

. Living in unstable home environments

. Presence of a non-biological caregiver

. Parents or caregivers with a history of abuse or criminal behaviour

. Substance abuse in the family

. Previous involvement with child protective services


i. A skeletal survey to identify fractures or other injuries.

ii. Additional imaging as indicated based on clinical findings.

iii. Blood tests for underlying conditions, if applicable


1. Immediate admission to a ward for monitoring and further evaluation

2. Pain relief and treatment of any underlying medical conditions

3. Informing the local safeguarding team about the suspected abuse

Referral to social services for immediate intervention and ongoing monitoring

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