A half century ago, Kempe and colleagues1published in JAMA “The Battered-Child Syndrome,” an article that would change the way physicians and others care for children with injuries. Although this article was not the first in the medical literature to address the problem of physical abuse of children, the authors did report the first epidemiologic study and highlighted important aspects of the evaluation of suspected abuse: (1) the discrepancy between the stated history and clinical findings, (2) questions that can be asked of parents when physicians are concerned about possible abuse, (3) some of the key physical examination and radiographic findings in abused children, (4) associated findings such as poor hygiene and failure to thrive, and (5) reasons physicians might have difficulty believing that parents can hurt their children.
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