Physical child abuse may be broadly defined as injury inflicted upon a child by a parent or caretaker. Specific definitions can vary widely among countries, as well as among different ethnic and religious groups.

●Abused children who are returned to an abusive environment without intervention are highly likely to be maltreated again and are at an increased risk for death.

●Careful history and physical examination and awareness of “red flags” for child physical abuse can prevent additional injury and may be life-saving.

●Young age, a prior history of abuse in the household, and social factors (eg, domestic violence, caregiver substance abuse or psychiatric illness, presence of family stressors, or family isolation) can also raise the level of concern for child physical abuse in equivocal cases. We recommend not using race or socioeconomic status to determine the need for further abuse evaluation.

•Actively maintaining child abuse in the differential diagnosis of trauma and puzzling medical presentations

•Careful evaluation for findings of abuse on history and physical examination.

•Utilization of multidisciplinary child abuse teams as consultants

•Prompt reporting of suspected child physical abuse to the appropriate governmental agency

●Evidence is lacking to support universal screening for abuse. Until better formal methods are developed which have acceptable accuracy and can be easily implemented, we favor the broad distribution and use of current guidelines among all pediatric health care providers to enhance general awareness and to support timely recognition of child physical abuse.