Childhood bruising

All clinicians caring for children will be challenged when faced with a young child covered with bruises. Ruling out leukaemia and idiopathic thrombocytopenia is relatively straight-forward with a blood count and film. Making a judgement about child abuse on the basis of the pattern of bruising is a core skill for every paediatrician; this is sometimes very hard. So can bruising characteristics distinguish abusive from non-abusive injury in young children? Pierce MC et al [JAMA Netw Open 2021;4:e215832. doi:10.1001/jamanetworkopen.2021.5832] have tackled this question and further developed a clinical decision rule. Over the last 20 years there have been a number of papers and rules published from different groups. This work is further validation of a previously derived bruising clinical decision rule (BCDR), the TEN-4 (bruising to torso, ear, or neck or any bruising on an infant <4.99 months of age. In a cross-sectional study of 2161 children younger than...

from Archives of Disease in Childhood current issue https://ift.tt/3v6nsis