In this section
Bruising is caused by bleeding under intact skin due to
trauma. Bruises are common childhood injuries. Bruising is also the most common
injury sustained by children who have been abused. Differentiating between
bruising from accidental and inflicted mechanisms can be challenging.
The following findings are concerning:
The age of a bruise cannot be determined on the basis of its
colour. Multiple bruises that appear different may have been sustained at the
The possibility that the child has a bleeding
disorder should be considered although it should be remembered that children
who have bleeding disorders can also sustain inflicted injuries.
If these criteria are met, have clinical concern for abuse:
be performed whenever Abusive Head Trauma is suspected and in selected
situations when disorders of coagulation are suspected)
investigations may be indicated
In young children who have intracranial bleeding (known or
suspected) then consider ordering additional tests of blood coagulation known
as “extended clotting studies”. These are second line investigations to be
performed in carefully selected cases.