Bruises (injury) highly associated with physical child abuse in children <4 years old (TEN-4-FACES-p)

T – Torso

E – Ear

N – Neck

F – Frenulum (including laceration or tear)

A – Angle of the jaw and any bruise in an infant <6 months old

C – Cheek (fleshy portion)

E – Eyelid

S – Subconjunctival hemorrhage

P – Patterned bruises (eg, loop, belt, handprint, or recognizable striking object)

Bruises with these characteristics often result from physical abuse. Children with these injuries warrant further evaluation and consultation with a multidisciplinary child abuse team. Refer to UpToDate topics on recognition, diagnosis, and management of physical child abuse.

Graphic 147542 Version 1.0

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Bruises (injury) highly associated with physical child abuse in children <4 years old (TEN-4-FACES-p)