Additionally, the results of a retrospective cohort study have reported that at least 25% of the children with suspected NAT experienced a recurring episode within one year of initial suspicion . A study reports that up to half of the physically battered children presented to an orthopedic surgeon, and 35% of these patients suffered through multiple occurrences of abuse with 10% of these victims meeting lethal consequences . These figures depicting NAT incidence are speculated to be largely underreported on accounts of misdiagnosis and unfamiliarity associated with abusive physical injuries .Ĭhild abuse contributes to significant pediatric mortality and morbidity as it often goes unidentified until a serious injury has been inflicted . NAT is documented to have the second greatest prevalence amongst the causes of pediatric mortality and is also reported to have an incidence that ranges from 0.47 to 2,000 per 100,000 . Purposefully inflicted injuries, regardless of the intention to cause harm, are considered “Nonaccidental trauma (NAT).” Child maltreatment is categorized either by the performance of a deliberate harmful act on a child or by the failure to ensure safety at the hands of a caregiver. Therefore, considering the multifactorial approach this subject requires, this review aims to delve into prevalence statistics, various risk factors, and their effect on psychological health to offer a near-complete regulation to ensure an effective understanding of NAT on part of doctors, social workers, and other relevant authorities.Īmbulatory children can suffer various injuries as a result of fairly foreseeable minor accidents that may occur during activities of routine play, therefore, highlighting a considerable need to distinguish these accidental wounds as well as several medical conditions and certain cultural healing practices from the traumatic injuries sustained during deliberate or neglectful acts of assault. Hence, there is a need to direct special focus on the importance of accurate history taking and immediate, responsible reporting to authorities, as well as to child protective services. An ineffective diagnosis can have detrimental emotional consequences for the family and may even expose the child to future potentially fatal episodes of abuse. The margin of error in cases of abuse is negligible, therefore, making its diagnosis a momentous as well as challenging clinical task. For effective results, it is essential to remain mindful of all background factors, such as the caregiver setting and the prevalence of child maltreatment in the concerned community while acknowledging the possibility of natural causes (genetic diseases such as osteogenesis imperfecta and hemophilia, or acquired abnormalities) that can mimic NAT and cause confusion in diagnosis and treatment. We analyze various abuse lesions such as radiological (visceral and skeletal lesions and those associated with head trauma) and cutaneous (burns, bruises, bites, etc.) to enhance streamlined identification of injuries in cases of physical child abuse. Child abuse is a preventable phenomenon of considerable concern resulting in significant child mortality and morbidity.
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