@article{ref1,
title="Additional injuries in young infants with concern for abuse and apparently isolated bruises",
journal="Journal of pediatrics",
year="2014",
author="Harper, Nancy S. and Feldman, Kenneth W. and Sugar, Naomi F. and Anderst, James D. and Lindberg, Daniel M.",
volume="165",
number="2",
pages="383-388.e1",
abstract="OBJECTIVE: To determine the prevalence of additional injuries or bleeding disorders in a large population of young infants evaluated for abuse because of apparently isolated bruising. STUDY DESIGN: This was a prospectively planned secondary analysis of an observational study of children <10 years (120 months) of age evaluated for possible physical abuse by 20 US child abuse teams. This analysis included infants <6 months of age with apparently isolated bruising who underwent diagnostic testing for additional injuries or bleeding disorders. <br><br>RESULTS: Among 2890 children, 33.9% (980/2890) were <6 months old, and 25.9% (254/980) of these had bruises identified. Within this group, 57.5% (146/254) had apparently isolated bruises at presentation. Skeletal surveys identified new injury in 23.3% (34/146), neuroimaging identified new injury in 27.4% (40/146), and abdominal injury was identified in 2.7% (4/146). Overall, 50% (73/146) had at least one additional serious injury. Although testing for bleeding disorders was performed in 70.5% (103/146), no bleeding disorders were identified. Ultimately, 50% (73/146) had a high perceived likelihood of abuse. <br><br>CONCLUSIONS: Infants younger than 6 months of age with bruising prompting subspecialty consultation for abuse have a high risk of additional serious injuries. Routine medical evaluation for young infants with bruises and concern for physical abuse should include physical examination, skeletal survey, neuroimaging, and abdominal injury screening.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2014.04.004",
url="http://dx.doi.org/10.1016/j.jpeds.2014.04.004"
}