Medical Evaluation for Child Physical Abuse
Medical Evaluation for Child Physical Abuse
A medical evaluation for suspected physical abuse should include a thorough oral inspection. Note any dental injuries. Inspect the lips and mucosa for any trauma. Examine the labial and sublingual frenula. Frenulum damage can occur in infants and young children from forcing an object such as a spoon, bottle, or pacifier into the mouth (Figure 7). When a torn frenulum is found in an infant, co-existing injuries are often present (Maguire, 2010). If a torn frenulum is found in a child younger than 2 years of age, a skeletal survey should be performed and a head CT scan and ophthalmology consult should be considered to diagnose occult skeletal, retinal, and/or intracranial trauma. Also consider testing liver and pancreatic enzymes to rule out occult abdominal trauma.
(Enlarge Image)
Figure 7.
A torn oral frenulum. This figure is available in color online at www.jpedhc.org.
Oral Injuries
A medical evaluation for suspected physical abuse should include a thorough oral inspection. Note any dental injuries. Inspect the lips and mucosa for any trauma. Examine the labial and sublingual frenula. Frenulum damage can occur in infants and young children from forcing an object such as a spoon, bottle, or pacifier into the mouth (Figure 7). When a torn frenulum is found in an infant, co-existing injuries are often present (Maguire, 2010). If a torn frenulum is found in a child younger than 2 years of age, a skeletal survey should be performed and a head CT scan and ophthalmology consult should be considered to diagnose occult skeletal, retinal, and/or intracranial trauma. Also consider testing liver and pancreatic enzymes to rule out occult abdominal trauma.
(Enlarge Image)
Figure 7.
A torn oral frenulum. This figure is available in color online at www.jpedhc.org.
