When Is a Fracture Suspicious for Child Abuse?
| • No history of injury |
| • History of injury not plausible—mechanism described not consistent with the type of fracture, the energy load needed to cause the fracture, or the severity of the injury |
| • Inconsistent histories or changing histories provided by caregiver |
| • Fracture in a nonambulatory child |
| • Fracture of high specificity for child abuse (eg, rib fractures) |
| • Multiple fractures |
| • Fractures of different ages |
| • Other injuries suspicious for child abuse |
| • Delay in seeking care for an injury |
| • No history of injury |
| • History of injury not plausible—mechanism described not consistent with the type of fracture, the energy load needed to cause the fracture, or the severity of the injury |
| • Inconsistent histories or changing histories provided by caregiver |
| • Fracture in a nonambulatory child |
| • Fracture of high specificity for child abuse (eg, rib fractures) |
| • Multiple fractures |
| • Fractures of different ages |
| • Other injuries suspicious for child abuse |
| • Delay in seeking care for an injury |