Child Abuse Differential Diagnoses

Updated: Jul 24, 2018
  • Author: Julia Magana, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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DDx

Diagnostic Considerations

The differential diagnosis depends on the type of injury, the age of the child, and the signs and symptoms. Most of the time, injury diagnosis is between accidental and inflicted trauma.

Bruise-related differential diagnoses are as follows:

  • Accidental bruises

  • Congenital dermal melanocytosis (Mongolian spots)

  • Hemangioma

  • Phytophotodermatitis

  • Immune thrombocytopenic purpura

  • Henoch-Schönlein purpura

  • Petechiae or subconjunctival hemorrhage from vomiting or coughing

  • Insect bites

  • Paint/ink on skin

  • Hemorrhagic disease of the newborn

  • Bleeding disorder (congenital or acquired)

  • Birth trauma

  • Hemophilia

  • Malignancy

  • Erythema multiforme

  • Folk healing practices (eg, coining, cupping)

  • Nevi

Skeletal fractures–related differential diagnoses are as follows:

  • Accidental fractures

  • Malignancy

  • Osteogenesis imperfecta

  • Rickets

  • Osteomyelitis

  • Bone fragility with chronic disease

  • Physiological subperiosteal new bone

  • Scurvy

  • Hypervitaminosis A

  • Congenital syphilis

  • Caffey disease

  • Birth trauma

  • Osteopenia of prematurity

  • Osteopenia

Burn-related differential diagnoses are as follows:

  • Accidental burns

  • Phytophotodermatitis

  • Impetigo

  • Folk healing practices (eg, coining, cupping)

  • Atopic dermatitis

  • Inflammatory conditions of the skin

  • Sunburn

  • Chemical burn

  • Contact dermatitis

Abusive head trauma (AHT)–related differential diagnoses are as follows:

  • Accidental head injury

  • Congenital or acquired coagulopathies (eg, hemophilia, vitamin K deficiencies, neonatal alloimmune thrombocytopenia)

  • Metabolic disease (eg, glutaric aciduria type 1)

  • Cerebral sinovenous thrombosis

  • Arteriovenous malformations

  • Unintentional asphyxia

  • Birth trauma

  • Bacterial meningitis

  • Leukemia

  • Solid brain tumors

  • Menkes disease