Signs of possible physical abuse include:
- Fractures unexpectedly discovered in the course of an otherwise routine medical examination (e.g., discovering a broken rib while listening to the child's heartbeat)
- Injuries that are inconsistent with, or out of proportion to, the history provided by the caretaker or with the child's age or developmental stage (e.g., a 3-month old burning herself by crawling on top of the stove)
- Multiple fractures, often symmetrical (e.g., in both arms or legs), or fractures at different stages of healing
- Fractures in children who are not able to walk
- Skeletal trauma (e.g., fractures) combined with other types of injuries, such as burns
- Subdural hematomas, which are hemorrhages between the brain and its outer lining that are caused by ruptured blood vessels
- Burns on the buttocks, around the anogenital region, on the backs of the hands, or on both hands, as well as those that are severe.