formation in the ribs. Exam: bruises on childs back. What is the most appropriate next step?
a. Check child protection register
b. Coagulation profile
c. Skeletal survey
d. Serum calcium
e. DEXA scan
answer: C
The following investigations are mandatory in any case of suspected physical abuse:
- full skeletal survey - radiology of the whole skeleton to look for old or undiagnosed fractures
- tests of clotting function, including full blood count for platelets.
- biochemistry, including bone biochemistry
- appropriate investigations of the head if indicated
- medical photography of any affected area
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