Suspect child abuse if you see these injuries

Here are some examples of suspicious injuries in children, according to Thomas Tryon, RN, an ED nurse at Thomas Jefferson University Hospital in Philadelphia:

— a spiral fracture, which might indicate a twisting or pulling force on the extremity instead of a fall;

— bruises with well-defined shapes, which could indicate the use of an object instead of the diffuse bruising often seen with falls;

— distinctive markings caused by shoe prints from kicks, straps, or belt marks;

— bilateral thoracic bruising, which might indicate a child was picked up, squeezed, and shaken;

— defensive wounds on the forearms of older children accompanying other injuries;

— bruises at various stages of healing, which might indicate repeated beating;

— a burn injury with a line of demarcation where possibly the child's extremity was forced into hot water and held there;

— the presence of a skull fracture in a small child, which reveals that a lot of force must have been applied. "It is hard to fracture a jaw by walking into a door," says Tryon.