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Child Abuse

Daniel Lindberg, MD, Ilene Claudius , MD, and Solomon Behar, MD
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As healthcare providers, we have to have heightened awareness about child abuse. Ilene and Sol discuss with Dan Lindberg, MD a child abuse expert on concerning findings that should raise your concern and what to do about them.


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Kimberly E. -

Hi, I know we need to report both child abuse and elderly abuse. I was wondering what imaging or labs would we order that is different for an elderly person?

Mizuho M., DO -

Kimberly, good question. In fact we hope to have a speaker on elder abuse specifically in the coming months. But in the interim, elderly are generally more evaluable than children (unless completely demented). I would focus your imaging based on their exam and your concerns. Most important would be to get them alone away from the potential perpetrator when inquiring/examing so that you optimize your chances of getting a good exam. Reassurance for their safety is also important and most will be reluctant to tell you of their previous "injuries" from the past.
Labs generally are not an absolute, unless suspecting abdominal trauma. If that is the case these patients (peds and adults/elderly alike) should be referred to an ED for further imaging (US/CT perhaps depending on scenario) and potentially LFT/lipase/UA but these are not routine and certainly should be obtained on a case-by-case basis when concerned for solid organ/bladder/renal injury.
From the UC's stand point, if you have an elderly person whom you suspect abuse, I would follow your UC protocol, report it and refer for further workup. I hope that helps.

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