Topic Overview

Certain types of injuries are common to physical abuse.

• Bruises. Bruising is the most common sign of physical abuse and can result from being slapped, punched, bitten, or hit with a belt, cord, or switch. Suspect physical abuse if a child has bruising in unusual places. Bruises on the buttocks, genitals, back, sides of the body, both sides of the face or head, or on the upper surface of the hands or feet are unlikely to have been caused accidentally. The pattern of a bruise mark may suggest the object used to injure the child.
• Burns. Intentional burns often have recognizable patterns. For example, scalding burns (which occur when a child is immersed in hot water) produce a distinct line where the burn meets undamaged skin. If a child's hands or feet were placed in hot water, the resulting burn may look as if he or she is wearing a glove or sock. Cigarette burns often occur in groups, are circular and the same size as the end of a cigarette, and are in places that do not seem likely to be accidental.
• Fractures. Abuse fractures are caused by twisting or pulling an arm or leg, or shaking a child so hard that the arms or legs flail about, causing traction on the end of the long bones. Punching or kicking a child may cause fractures of the ribs, scapula, or sternum.
• Head injuries. Most abuse deaths are caused by injuries to the brain. Shaking or hitting a child's head or face is always dangerous. Young children cannot control the movement of their head as well as adults can. Shaken baby syndrome (shaken baby–impact syndrome) is brain damage caused when a baby is shaken, slammed, or thrown against an object.
• Abdominal injuries. A severe blow to the abdomen with a fist or foot can cause damage to internal organs. A ruptured spleen or liver, a hole or cut (perforation) in the intestines, a large blood clot (hematoma), or a bowel obstruction can occur with physical abuse to the abdomen.