How Accurately Can Bruises Be Aged in Abused Children?
ARI J. SCHWARTZ BA1, LAWRENCE R. RICCI MD1 1 Child Abuse Program at Spurwink Clinic, Portland, Maine Unlike the severe abuse that was reported in early child abuse literature, more moderate injuries comprise 60% of physical child abuse. These less-severe abuse cases, many with limited, ill-defined bruising, may be more difficult to diagnose than a severe case with multiple-system injury or a child with specific, clearly imprinted bruising. Additionally, as the US Supreme Court observed, “Child abuse is one of the most difficult crimes to detect and prosecute in large part because there often are no witnesses except the victim. Estimates of ages of bruises along with the aging of other injuries such as fractures and brain trauma may offer the only way to associate an injury with a particular perpetrator. Yet, as an aid to child abuse diagnosis and perpetrator identification, visual aging of bruises remains an inexact science, despite recent composite charts that suggest otherwise. Even
