Patients were sorted as abused if and when any of the following were true.
Primary caregiver admission of abusive acts
Primary caregiver denial of any head trauma, even though the pre-ambulatory child in his or her care became acutely, clearly and persistently ill with clinical signs subsequently linked to traumatic cranial injuries visible on CT or MR imaging
Primary caregiver account of the child’s head injury event that was clearly historically inconsistent with repetition over time
Primary caregiver account of the child’s head injury event that was clearly developmentally inconsistent with child’s known (or expected) gross motor skills
Two or more categories of extra-cranial injuries considered moderately or highly suspicious for abuse *   Classic metaphyseal lesion fracture(s) or epiphyseal separation(s) Rib fracture(s) Fracture(s) of the scapula or sternum Fracture(s) of digits vertebral body fracture(s), dislocation(s) or fracture(s) of spinous process(es) skin bruising, abrasion(s) or laceration(s) in two or more distinct locations other than knees, shins or elbows; patterned skin bruising or dry contact burn(s); scalding burn(s) with uniform depth, clear lines of demarcation and paucity of splash marks; confirmed intra-abdominal injuries; retinoschisis confirmed by an ophthalmologist; retinal hemorrhages described by an ophthalmologist as dense, extensive, covering a large surface area and/or extending to the ora serrata.

 

 

* Including the followoing:

 

 

Patients were sorted as abused if and when any of the following were true.

• Primary caregiver admission of abusive acts
• Primary caregiver denial of any head trauma, even though the pre-ambulatory child in his or her care became acutely, clearly and persistently ill with clinical signs subsequently linked to traumatic cranial injuries visible on CT or MR imaging
• Primary caregiver account of the child’s head injury event that was clearly historically inconsistent with repetition over time
• Primary caregiver account of the child’s head injury event that was clearly developmentally inconsistent with child’s known (or expected) gross motor skills
• Two or more categories of extra-cranial injuries considered moderately or highly suspicious for abuse, including
  • Classic metaphyseal lesion fracture(s) or epiphyseal separation(s)
  • Rib fracture(s) Fracture(s) of the scapula or sternum
    Fracture(s) of digits
    vertebral body fracture(s), dislocation(s) or fracture(s) of spinous process(es)
    skin bruising, abrasion(s) or laceration(s) in two or more distinct locations other than knees, shins or elbows;
    patterned skin bruising or dry contact burn(s);
    scalding burn(s) with uniform depth, clear lines of demarcation and paucity of splash marks;
    confirmed intra-abdominal injuries;
    retinoschisis confirmed by an ophthalmologist;
    retinal hemorrhages described by an ophthalmologist as dense, extensive, covering a large surface area and/or extending to the ora serrata.

 

 

 

 

 

 

 

 

• Classic metaphyseal lesion fracture(s) or epiphyseal separation(s);
• Rib fracture(s)
• Fracture(s) of the scapula or sternum; fracture(s) of digits;
• vertebral body fracture(s),
• dislocation(s) or fracture(s) of spinous process(es);
• skin bruising, abrasion(s) or laceration(s) in two or more distinct locations other than knees, shins or elbows;
• patterned skin bruising or dry contact burn(s);
• scalding burn(s) with uniform depth,
• clear lines of demarcation and paucity of splash marks;
• confirmed intra-abdominal injuries;
• retinoschisis confirmed by an ophthalmologist;
• retinal hemorrhages described by an ophthalmologist as dense, extensive, covering a large surface area and/or extending to the ora serrata.