Which description best fits non-accidental injury patterns in children?

• A. Bruising to ears, face, abdomen, arms, legs, buttocks, and hands
• B. Bruising only on elbows
• C. Bruising only on ankles
• D. Bruising symmetrical on both feet

Answer: (A)

Bruising that spans many areas of the body, including unusual sites like the ears and face, and involves multiple regions such as the abdomen, arms, legs, buttocks, and hands, is a strong pattern for non-accidental injury. Accidents tend to produce injuries in more limited, expected locations from a single incident—often on shins, elbows, knees, or other surfaces likely to be struck in a fall—and usually in a single event. When you see bruises in these atypical places and across several parts of the body, especially if there are bruises at different healing stages, it suggests repeated harm rather than a single accidental event.

Context matters: in young children, especially those who aren’t walking yet, widespread or unusual bruising is particularly concerning and should prompt careful evaluation and safeguarding actions. The other descriptions describe injuries more typical of single, accidental events or more localized patterns, and thus are less indicative of non-accidental injury.