Awareness of child abuse and neglect has been increasing since the publication of "The Battered Child Syndrome" by Kempe et al1 in 1962. In fact, only 447 cases of child abuse were reported in 1962, a number that increased to 2.9 million reported cases in 1992.1,2 Several articles,2-9 including diagnostic guidelines,10 have been published to help physicians recognize the manifestations of child abuse. Despite these advancements, the diagnosis of child maltreatment can be very difficult to make. It is often difficult to distinguish between accidental and nonaccidental injury. Additionally, several medical conditions have been cited in literature around the world that may mimic the physical manifestations of child abuse, adding further confusion.11-28 It is also possible for a physician to be misled by the social situation of a patient. We report a case of a child with an extremely concerning social situation who was initially thought to be a victim of child abuse, but actually had a common medical condition with a confusing presentation.
Daly KC, Siegel RM. Henoch-Schönlein Purpura in a Child at Risk of Abuse. Arch Pediatr Adolesc Med. 1998;152(1):96–98. doi:
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