Early identification of bruises resulting from child abuse can allow for intervention and prevent further abuse.Bruises seen in infants, especially on the face and buttocks, are more suspicious and should be considered nonaccidental until proven otherwise.One of the easiest ways to identify the weapon used to inflict bruises is to ask the caretaker: How were you punished as a child?The pattern of a skin lesion may suggest the type of instrument used.Injuries to children's upper arms (caused by efforts to defend themselves), the trunk, the front of their thighs, the sides of their faces, their ears and neck, genitalia, stomach, and buttocks are also more likely to be associated with nonaccidental injuries.Injuries to their shins, hips, lower arms, forehead, hands, or the bony prominences (the spine, knees, nose, chin, or elbows) are more likely to signify accidental injury.Bruise or wound configurations from objects can be divided into two main categories: those from "fixed" objects, which can only strike one of the body's planes at a time, and those from "wraparound" objects, which follow the contours of the body and strike more than one of the body's planes.
In some cases, however, bruises are acquired innocently, through play and accidental falls, or when a child has a defect in his or her clotting mechanism.
This would be suspicious because: Another child might have both bright red and brown bruises.
The caretaker maintains that all of the bruises were the result of a fall that day.
The medical diagnosis of clotting disorders requires blood tests and interpretation of those tests by qualified physicians.
Therefore, law enforcement officers should try to determine if bruises are the result of an accident or due to physical abuse.