9 These studies give limited insight into 'day-to-day' patterns of bruising in children.
3 However there is a small literature base defining 'normal' patterns of bruising.
They must therefore understand the patterns of bruising in children from day-to-day activities, and any influential factors.
The informed consent described the reasoning behind the study, including a need to identify normal patterns of bruising to compare with bruising in child abuse.
Features in the presenting history, the extent and pattern of bruising differed between children with confirmed PA and those where abuse was excluded.
This study confirms that while every child presents with a unique combination of features and circumstances, when analysed on a population basis, distinct patterns of bruising emerge that differ between children with confirmed PA and those with PA-excluded.
Petechiae, linear or bruises with distinct pattern, bruises in clusters, additional injuries or a child known to social services for previous child abuse concerns were significantly more likely in PA.
A chiffon tunic draped over narrow pants was a more energetic version of the layered dresses, which were sometimes impregnated with a tulip head pattern in bruised plum colors.
Forensic examination revealed that majority of cases were abused by blunt instruments manifested as patterned abrasions and bruises (71.5%), while seven victims out of 28 cases were abused by intentional burns (25%).
None of gender, season or the level of social deprivation significantly influenced bruising patterns, although having a sibling increased the mean number of bruises.
