This article stresses the importance of the “sentinel injury,” a physical injury that is unusual for the age of the child and may herald more serious injuries, thereby necessitating further evaluation.

Before receiving a diagnosis of child abuse, 25% to 30% of abused infants have “sentinel” injuries, such as facial bruising, noted by clinicians or caregivers. (1)(2)(3)(4)(5)(6) Although easily overlooked and often considered minor, such injuries are harbingers warning clinicians that pediatric patients require further assessment. Appropriate intervention is critical, and the clinician plays a major role in identifying children who present with signs or symptoms concerning for child physical abuse by ensuring appropriate and expeditious medical evaluations and reports to child protective services.

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A private practice pediatrician receives a phone call from a community emergency department (ED)...

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