I. Skeletal survey is necessary in children <24 months old with bruising if any of the following features are present: |
- History of confessed abuse
- History of bruising occurring during domestic violence
- Additional injuries on physical exam (eg, burns, whip marks)
- Patterned bruising
- >4 bruises NOT limited to bony prominences
- Ear, neck, torso, buttocks, genital region, hands, feet if there is no history of trauma
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II. Skeletal survey is also necessary in children <12 months old with bruising in the following locations: |
- Cheeks, eye area, ear, neck
- Upper arms or legs (not over bony prominences)
- Hands, feet
- Torso, buttocks, genital region
- >1 bruise NOT limited to bony prominences
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III. Skeletal survey is also necessary in children <9 months old with bruising in the following locations: |
- >1 bruise in ANY location
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IV. Skeletal survey is also necessary in children <6 months old with bruising in the following locations: |
- Bony prominences (head T-shaped area, frontal scalp, extremity bony prominences) EXCEPT if a single bruise and patient presents with history of fall
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