PSYCHOBEHAVIORAL DISORDERSTREATMENT
Treat injuries. Child Protective Services should be immediately contacted.
Intimate Partner Violence and Abuse (IPVA)
IPVA crosses all demographic and socioeconomic boundaries. Victims are
usually women but are increasingly male.
RISKFACTORS
Partner with alcohol or substance abuse problems, recent unemployment or
intermittent employment, history of police arrest, low educational attainment,
or having experienced abuse as a child
SYMPTOMS/EXAM
■ Patient presents with physical injuries, most commonly of head, neck, face,
chest, breasts, and abdomen.
■ Patient also can present with a wide variety of medical conditions, with
pain as a common presenting symptom (eg, headache, pelvic pain, vaginal
infections, depression, anxiety).
DIAGNOSIS
Suspect IPVA if stated mechanism of injury does not correlate with physical
exam.Ask patient directly!
FIGURE 16.4. Rib fractures.
(Reproduced, with permission, from Skinner HB, et al. Current Diagnosis and Treatment in
Orthopedics,4th ed. New York: McGraw-Hill, 2006: 644.)