New series on child abuse on UBM Medica's Pediatrics Consultant Live

UBM Medica's Pediatrics Consultant Live (www.PediatricsConsultantLive.com) has a new series called "Child Abuse–or Mimic?" which helps clinicians distinguish cases of child abuse from pediatric disease or mere accidents.

Child abuse is rampant and under-reported, but the consequences of mis-identifying abuse and wrongly accusing a parent also are dire. "Child Abuse–or Mimic?" builds physicians' diagnostic confidence so children get help quickly.  

Each case in the series describes the real-life story of a patient referred to child protective services because of suspect marks and bruises consistent with signs of child abuse. After reading the clinical details and viewing relevant photos, physicians decide whether they think the patient has been abused. Section editor Dr. Gregory Wallace, who has specialized in child abuse for over 20 years, selects and writes the cases.

One recent case focused on a fussy infant. A CT revealed a brain hemorrhage. The final diagnosis? Cystic Fibrosis. Mis-identifying his bleeding as the result of abuse would have delayed his treatment.

Another case involved a non-verbal girl with a neurological condition and bruising on her pelvis. A day-care worker reported the case to protective services. The parents denied abuse, claiming the girl fell getting out of the shower. Luckily, a home visit revealed how unlikely it was that a fall would bruise the girl where she was injured. Confronted by police, the father confessed abuse.

Other symptoms reviewed include bruising, perianal rash, and treatment-resistant ADD/ADHD.

"Numerous children who are brought to primary care offices or the ED with seemingly mundane case histories are actually victims of abuse. A complete history and thorough investigation can make the difference in the final outcome. Many abused children present for medical care with minor trauma and are not properly identified: they often present later with more serious trauma," comments Dr. Wallace.

According to the American Academy of Pediatrics (AAP), nearly 3 million cases of child abuse and neglect involving almost 5.5 million children are reported each year in the United States. The majority of cases reported to Child Protective Services involve neglect, followed by physical and sexual abuse – though there is considerable overlap, with many abused children suffering a combination of neglect, physical abuse, and/or sexual abuse.

"This series and the teaching points that are offered with each case will help serve a critically important public health need," said Sue Kweskin, editor of Pediatrics Consultant Live. "Our goal is to promote the safety and welfare of a large group of potentially vulnerable people who often fall through the cracks of the healthcare system."