{"id":158,"date":"2014-03-17T02:48:35","date_gmt":"2014-03-17T02:48:35","guid":{"rendered":"https:\/\/www.pupdoc.ca\/?page_id=158"},"modified":"2025-09-13T15:52:49","modified_gmt":"2025-09-13T15:52:49","slug":"inadequately-explained-injury","status":"publish","type":"page","link":"https:\/\/www.pupdoc.ca\/en\/inadequately-explained-injury\/","title":{"rendered":"Inadequately explained injury"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; inner_shadow=&#8221;on&#8221; fullwidth=&#8221;on&#8221; _builder_version=&#8221;4.25.1&#8243; background_color=&#8221;#961622&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header title=&#8221;Inadequately explained injury&#8221; subhead=&#8221;(Child abuse)&#8221; text_orientation=&#8221;center&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;rgba(255, 255, 255, 0)&#8221; button_one_letter_spacing_hover=&#8221;0&#8243; button_two_letter_spacing_hover=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_one_text_size__hover=&#8221;null&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover=&#8221;null&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_one_text_color__hover=&#8221;null&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover=&#8221;null&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_one_border_width__hover=&#8221;null&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover=&#8221;null&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_one_border_color__hover=&#8221;null&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover=&#8221;null&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover=&#8221;null&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover=&#8221;null&#8221; button_one_letter_spacing__hover_enabled=&#8221;on&#8221; button_one_letter_spacing__hover=&#8221;0&#8243; button_two_letter_spacing__hover_enabled=&#8221;on&#8221; button_two_letter_spacing__hover=&#8221;0&#8243; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover=&#8221;null&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover=&#8221;null&#8221;][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; inner_shadow=&#8221;on&#8221; _builder_version=&#8221;4.25.1&#8243; background_color=&#8221;#ffffff&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.25.1&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_tabs module_class=&#8221;key-conditions&#8221; _builder_version=&#8221;4.25.1&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; hover_enabled=&#8221;0&#8243; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_tab title=&#8221;Key Conditions&#8221; _builder_version=&#8221;4.25.1&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; global_colors_info=&#8221;{}&#8221;]Traumatic head injury due to child maltreatment<br \/>\nIntimate partner violence<br \/>\nNeglect<br \/>\nPhysical abuse<br \/>\nSexual abuse[\/et_pb_tab][et_pb_tab title=&#8221;Foundational Knowledge&#8221; _builder_version=&#8221;4.25.1&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul>\n<li>Define the different types of child maltreatment<\/li>\n<li>Recognize typical and atypical patterns of injury in children<\/li>\n<\/ul>\n<p>[\/et_pb_tab][et_pb_tab title=&#8221;Resources&#8221; _builder_version=&#8221;4.25.1&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Overview &amp; Foundational Knowledge<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>The Pediatrician\u2019s Role in Preventing Child Maltreatment: Clinical Report<\/strong><\/p>\n<p><a href=\"https:\/\/doi.org\/10.1542\/peds.2024-067608\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/doi.org\/10.1542\/peds.2024-067608<\/a><\/p>\n<p><em>Stirling J, Gavril A, Brennan B, et al. The Pediatrician\u2019s Role in Preventing Child Maltreatment: Clinical Report. Pediatrics. 2024;154(2):e2024067608. doi:10.1542\/peds.2024-067608<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Maguire S. Which injuries may indicate child abuse?  Arch Dis Child Educ Pract Ed 2010 95: 170-177.<\/strong><\/p>\n<p><a href=\"http:\/\/ep.bmj.com\/content\/95\/6\/170\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/ep.bmj.com\/content\/95\/6\/170<\/a><\/p>\n<p><em>Overview article in BMJ.<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div><\/p>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Clinical Resources<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Christian CW et al. The Evaluation of Suspected Child Physical Abuse.  <em>Pediatrics<\/em> 2015: 135 (5): e1337e1355<\/strong><\/p>\n<p><a href=\"http:\/\/pediatrics.aappublications.org\/content\/135\/5\/e1337\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/pediatrics.aappublications.org\/content\/135\/5\/e1337<\/a><\/p>\n<p><em>Good guidelines outlining evaluation of children where physical abuse is suspected.<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>CPS Practise Point: Medical assessment of suspected traumatic head injury due to child maltreatment (THI-CM) (2024)<\/strong><\/p>\n<p><a href=\"https:\/\/cps.ca\/en\/documents\/position\/medical-assessment-of-THI-CM\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/en\/documents\/position\/medical-assessment-of-THI-CM<\/a><\/p>\n<p><a href=\"https:\/\/cps.ca\/fr\/documents\/position\/evaluation-medicale-du-TC-ME\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/fr\/documents\/position\/evaluation-medicale-du-TC-ME<\/a><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td><strong>CPS Practise Point: The medical assessment of fractures in suspected child maltreatment: Infants and young children with skeletal injury (2018)<\/strong><\/p>\n<p><a href=\"https:\/\/cps.ca\/en\/documents\/position\/fractures-in-suspected-child-maltreatment\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/en\/documents\/position\/fractures-in-suspected-child-maltreatment<\/a><\/p>\n<p><a href=\"https:\/\/cps.ca\/fr\/documents\/position\/levaluation-medicale-des-fractures-en-cas-de-soupcons-de-maltraitance\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/fr\/documents\/position\/levaluation-medicale-des-fractures-en-cas-de-soupcons-de-maltraitance<\/a><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td><strong>CPS Practise Point: The medical assessment of bruising in suspected child maltreatment cases: A clinical perspective (2017)<\/strong><\/p>\n<p><a href=\"http:\/\/www.cps.ca\/en\/documents\/position\/medical-assessment-of-bruising\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/www.cps.ca\/en\/documents\/position\/medical-assessment-of-bruising<\/a><\/p>\n<p><a href=\"http:\/\/www.cps.ca\/fr\/documents\/position\/evaluation-medicale-des-ecchymoses\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/www.cps.ca\/fr\/documents\/position\/evaluation-medicale-des-ecchymoses<\/a><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td><strong>CPS Practise point: Recognizing and responding to children with suspected exposure to intimate partner violence between caregivers (2023)<\/strong><\/p>\n<p><a href=\"https:\/\/cps.ca\/en\/documents\/position\/recognizing-and-responding-to-children-with-suspected-exposure-to-intimate-partner-violence-between-caregivers\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/en\/documents\/position\/recognizing-and-responding-to-children-with-suspected-exposure-to-intimate-partner-violence-between-caregivers<\/a><\/p>\n<p><a href=\"https:\/\/cps.ca\/fr\/documents\/position\/savoir-detecter-lexposition-des-enfants-a-la-violence-entre-partenaires-intimes-quelle-soit-presumee-ou-divulguee-et-savoir-intervenir\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/fr\/documents\/position\/savoir-detecter-lexposition-des-enfants-a-la-violence-entre-partenaires-intimes-quelle-soit-presumee-ou-divulguee-et-savoir-intervenir<\/a><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Virtual Patients or Cases<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Altered Level of Consciousness.<\/strong><\/p>\n<p>Access through <a href=\"https:\/\/www.pedscases.com\/altered-level-consciousness\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.pedscases.com\/altered-level-consciousness<\/a><\/p>\n<p><em>Patient case on altered level of consciousness.<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>[\/et_pb_tab][\/et_pb_tabs][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; _builder_version=&#8221;3.19.9&#8243; background_color=&#8221;#eeeeee&#8221; global_module=&#8221;2263&#8243; collapsed=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header text_orientation=&#8221;center&#8221; logo_image_url=&#8221;https:\/\/www.pupdoc.ca\/wp-content\/uploads\/2018\/12\/canuc-paeds.png&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;rgba(255, 255, 255, 0)&#8221; background_layout=&#8221;light&#8221; max_width_tablet=&#8221;50px&#8221; custom_padding=&#8221;7px|0px|0px|0px&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; custom_css_main_element=&#8221;max-height: max-content;&#8221; global_colors_info=&#8221;{}&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_one_letter_spacing__hover_enabled=&#8221;off&#8221; button_two_letter_spacing__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221;][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#ffffff&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_3,1_3,1_3&#8243; _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; custom_margin=&#8221;||0px|&#8221; custom_margin_tablet=&#8221;&#8221; custom_margin_phone=&#8221;&#8221; custom_margin_last_edited=&#8221;on|tablet&#8221; custom_padding=&#8221;||0px|&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;||0px|&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px|&#8221; custom_margin_tablet=&#8221;&#8221; custom_margin_phone=&#8221;&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; custom_padding=&#8221;||0px|&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/abdominal-pain-abdominal-mass\/\">Abdominal Pain &amp; Abdominal Mass<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/acutely-ill-child\/\">Acutely Ill Child<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/adolescent-health-issues\/\">Adolescent Health Issues<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/altered-loc\/\">Altered Level of Consciousness<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/bruising-bleeding\/\">Bruising \/ Bleeding<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/dehydration\/\">Dehydration<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/development-behavioural-learning-problems\/\">Development \/ Behavioural \/ Learning Problems<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/diarrhea\/\">Diarrhea<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/edema\/\">Edema<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/eye-issues\/\">Eye Issues<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;||0px|&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px|&#8221; custom_padding=&#8221;||0px|&#8221; custom_css_main_element=&#8221;margin-bottom: 0px !important;&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/fever\/\">Fever<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/genitourinary-complaints\/\">Genitourinary Complaints<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/growth-problems\/\">Growth Problems<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/headache\/\">Headache<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/inadequately-explained-injury\/\"><strong>Inadequately explained injury<\/strong><\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/limp-extremity-pain\/\">Limp \/ Extremity Pain<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/lymphadenopathy\/\">Lymphadenopathy<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/mental-health-concerns\/\">Mental Health Concerns<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/murmur\/\">Murmur<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/neonatal-jaundice\/\">Neonatal Jaundice<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/newborn\/\">Newborn<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/pallor-anemia\/\">Pallor \/ Anemia<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/rash\/\">Rash<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/respiratory-distress-cough\/\">Respiratory distress \/ Cough<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/seizure-paroxysmal-event\/\">Seizure \/ Paroxysmal event<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/sore-ear\/\">Sore Ear<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/sore-throat-sore-mouth\/\">Sore Throat \/ Sore Mouth<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/vomiting\/\">Vomiting<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/well-child-care\/\">Well Child Care<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Traumatic head injury due to child maltreatment Intimate partner violence Neglect Physical abuse Sexual abuse Define the different types of child maltreatment Recognize typical and atypical patterns of injury in children <div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Overview &amp; Foundational Knowledge<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><\/div>\n\t\t\t\t<\/div> The Pediatrician\u2019s Role in Preventing Child Maltreatment: Clinical Report https:\/\/doi.org\/10.1542\/peds.2024-067608 Stirling J, Gavril A, Brennan B, et al. The [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-158","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/158","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/comments?post=158"}],"version-history":[{"count":12,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/158\/revisions"}],"predecessor-version":[{"id":2979,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/158\/revisions\/2979"}],"wp:attachment":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/media?parent=158"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}