0071643192.pdf

PSYCHOBEHAVIORAL DISORDERS

790

DIAGNOSIS

■ History and physical exam

■ Skeletal survey, ophthalmologic exam, head CT if indicated

■ Fractures that raise suspicion of abuse:

■ Any fracture in a child <2 years old

■ Fracture of rib, scapula, vertebral body, spinous process, sternum (see

Figure 16.4)

■ Metaphyseal injuries, including a chip fracture or bucket-handle fracture

■ Skull fracture

■ Spiral or transverse diaphyseal fracture (any long bone fracture on a

perambulatory child)

■ Fractures of different ages

FIGURE 16.2. Burns on buttocks.

(Reproduced, with permission, from Weinberg S, et al.Color Atlas of Pediatric Dermatology,

3rd ed. New York: McGraw-Hill, 1998:240.)

FIGURE 16.3. Loop marks from hanger.

(Reproduced, with permission, from Weinberg S, et al.Color Atlas of Pediatric Dermatology, 3rd ed.

New York: McGraw-Hill, 1998:240.)