Nonaccidental Injuries in Children



“CALL DR” is a mnemonic for the key steps in the emergency department “pathway” for nonaccidental injury.


Child Abuse Osteogenesis Imperfecta Club Foot Retinal Haemorrhage Skeletal Survey 


  1. 1.
    Krug EG, et al., editors. World report on violence and health. Geneva: World Health Organization (WHO); 2002.Google Scholar
  2. 2.
    Kodner C, Wetherton A. Diagnosis and management of physical abuse in children. Am Fam Physician. 2013;88(10):669–75.PubMedGoogle Scholar
  3. 3.
    Kellogg ND, A. American Academy of Pediatrics Committee on Child, and Neglect. Evaluation of suspected child physical abuse. Pediatrics. 2007;119(6):1232–41.CrossRefPubMedGoogle Scholar
  4. 4.
    Saperia J, et al. When to suspect child maltreatment: summary of NICE guidance. BMJ. 2009;339:b2689.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Smith A. Nonaccidental injury in childhood. Aust Fam Physician. 2011;40(11):858–61.PubMedGoogle Scholar
  6. 6.
    Leetch AN, Woolridge D. Emergency department evaluation of child abuse. Emerg Med Clin North Am. 2013;31(3):853–73.CrossRefPubMedGoogle Scholar
  7. 7.
    Ministry of Community, Y.a.S.M., Singapore, National Standards for Protection of Children. Singapore; 2002.Google Scholar
  8. 8.
    Maguire S, et al. Are there patterns of bruising in childhood which are diagnostic or suggestive of abuse? A systematic review. Arch Dis Child. 2005;90(2):182–6.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Maguire S, Mann M. Systematic reviews of bruising in relation to child abuse-what have we learnt: an overview of review updates. Evid Based Child Health. 2013;8(2):255–63.CrossRefPubMedGoogle Scholar
  10. 10.
    Pierce MC, et al. Bruising characteristics discriminating physical child abuse from accidental trauma. Pediatrics. 2010;125(1):67–74.CrossRefPubMedGoogle Scholar
  11. 11.
    Sugar NF, Taylor JA, Feldman KW. Bruises in infants and toddlers: those who don’t cruise rarely bruise. Puget Sound Pediatric Research Network. Arch Pediatr Adolesc Med. 1999;153(4):399–403.CrossRefPubMedGoogle Scholar
  12. 12.
    Langlois NE, Gresham GA. The ageing of bruises: a review and study of the colour changes with time. Forensic Sci Int. 1991;50(2):227–38.CrossRefPubMedGoogle Scholar
  13. 13.
    Hobbs CJ. ABC of child abuse. Burns and scalds. BMJ. 1989;298(6683):1302–5.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Maguire S, et al. A systematic review of the features that indicate intentional scalds in children. Burns. 2008;34(8):1072–81.CrossRefPubMedGoogle Scholar
  15. 15.
    Flaherty EG, et al. Evaluating children with fractures for child physical abuse. Pediatrics. 2014;133(2):e477–89.CrossRefPubMedGoogle Scholar
  16. 16.
    Kemp AM, et al. Patterns of skeletal fractures in child abuse: systematic review. BMJ. 2008;337:a1518.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kleinman PK. Diagnostic imaging of child abuse. 2nd ed. St. Louis: Mosby; 1998.Google Scholar
  18. 18.
    Ayoub DM, et al. A critical review of the classic metaphyseal lesion: traumatic or metabolic? AJR Am J Roentgenol. 2014;202(1):185–96.CrossRefPubMedGoogle Scholar
  19. 19.
    Piteau SJ, et al. Clinical and radiographic characteristics associated with abusive and nonabusive head trauma: a systematic review. Pediatrics. 2012;130(2):315–23.CrossRefPubMedGoogle Scholar
  20. 20.
    Christian CW, et al. Abusive head trauma in infants and children. Pediatrics. 2009;123(5):1409–11.CrossRefPubMedGoogle Scholar
  21. 21.
    Wood JN, et al. Development of guidelines for skeletal survey in young children with fractures. Pediatrics. 2014;134:45–53.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Department of Emergency MedicineKK Women’s and Children’s HospitalSingaporeRepublic of Singapore

Personalised recommendations