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A complicated and challenging scenario arises when the caregiver accuses an adult from whom the caregiver is divorced or separated as the perpetrator.
When possible, separate interviews should be held for the caregiver(s) and the child.
The physical manifestations of nonaccidental trauma are varied and most commonly involve the skin, bone or central nervous system.
Nonaccidental trauma may affect any organ system and mimic signs of accidental trauma or other disease processes.
However, injury resulting from inappropriate supervision may raise the issue of neglect, a form of child abuse.
When the patient's injuries are attributed to another child, the other child's developmental ability must be considered.