About the review
Bruising is the commonest injury in physical child abuse.
The number of bruises a child sustains increases as they get older and their level of independent mobility increases.
There can be difficulty in distinguishing abusive from non-abusive bruises and determining the age of the bruise when attempting diagnoses.
This systematic review evaluates the scientific literature on abusive and non-abusive bruising in children published up until February 2016.
It aims to answer two clinical questions:
- Which patterns are suggestive of abuse?
- Can a bruise be accurately aged?
The implications for practice and research and other useful references are included in the review.
- In the most recent update, no new studies relating to the pattern or aging of bruises have been published that met the inclusion criteria.
- However, there is an increasing body of literature addressing optimal imaging of bruises
Further cases have been reported where bruising was a “sentinel injury” in children prior to the recognition of child abuse, highlighting the importance of recognising abnormal patterns of bruising in young infants.
Disclaimer: This is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates
Original reviews and content © Cardiff University, funded by NSPCC
Published by RCPCH July 2017
While the format of each review has been revised to fit the style of the College and amalgamated into a comprehensive document, the content remains unchanged until reviewed and new evidence is identified and added to the evidence-base. Updated content will be indicated on individual review pages.