Excluding medical and haematological conditions as a cause of bruising in suspected non-accidental injury

• Published in: Archives of disease in childhood. Education and practice edition Vol. 95; no. 1; p. 2
• Main Authors: Minford, A M B, Richards, E M
• Format: Journal Article
• Language: English
• Published: England 01-02-2010
• Subjects: Benchmarking; Child; Child Abuse - diagnosis; Contusions - diagnosis; Contusions - epidemiology; Contusions - etiology; Family Health; Hematologic Diseases - complications; Hematologic Diseases - diagnosis; Hematologic Diseases - epidemiology; Humans; Incidence; Pediatrics - methods; Pediatrics - standards; Prevalence; Wounds and Injuries - diagnosis; Wounds and Injuries - epidemiology; Wounds and Injuries - etiology
• ISSN: 1743-0593
• DOI: 10.1136/adc.2009.159707

A mistaken diagnosis of child abuse can occur in a number of medical conditions, many of which can be readily diagnosed by experienced paediatricians. Bleeding disorders offer a greater challenge, especially when court proceedings may demand their exclusion. Some of these disorders are rare but more prevalent in areas which have a high incidence of consanguinity. We advocate two stages of laboratory investigations but the limitations of some of these tests and their inability to exclude a bleeding disorder with absolute certainty should be recognised. However, if personal and family histories are absent and both first-stage and second-stage investigations are normal, it is highly unlikely that a bleeding disorder will be missed.