These children have a history of being repeatedly beaten by a caregiver. The injuries occur over a period of weeks, months, and years. Usually there are numerous injuries of different ages. It is common to see a child with healing rib fractures and old contusions in addition to the recent injuries which caused death. The external injuries to the head from blunt trauma may only be visible on the undersurface of the scalp. Contusions of the trunk may be readily apparent or absent even though there are fatal injuries to the internal organs.
All injuries should be photographed. Signs of sexual abuse will be determined by the pathologist.
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