When to suspect child maltreatment: summary of NICE guidance

Physical features Physical features include any serious or unusual injury with an absent or unsuitable explanation, and particularly in the following categories: abrasions, bites, bruises, burns, cold injuries, cuts, lacerations, ligature marks, petechiae, scalds, scars, and strangulation marks. They also include various sites of internal injury including fractures, spinal and intracranial injuries (including subdural haemorrhage), intraabdominal and intrathoracic injuries, eye injuries (including retinal haemorrhage), and oral injuries. The recommendations describe specific attributes of these injuries and of the child that should lead the healthcare professional to consider or suspect child maltreatment; in so doing, the recommendations draw attention to the age and developmental stage of the child and the suitability of the explanation given by the parents or carers.